In implant-based breast reconstruction, an implant is used to recreate the breast form in order to reproduce the
desired shape and volume of the breast and to restore to the best degree possible reasonable symmetry of your breasts.
Breast reconstruction using an implant can be completed in one of two ways: in a Direct-to-Implant Reconstruction
(also known as a One-Stage Reconstruction), or a
Tissue Expander-to-Implant Reconstruction (known as a
Two-Stage Reconstruction).
In some cases, after a mastectomy, a surgeon may recommend inserting the implant (made of silicone or saline) directly
without having to expand the breast pocket with an expander. This is called a Direct-to-Implant or One-Stage Reconstruction.
Alternatively, in Tissue Expander-to-Implant or Two-Stage Reconstruction, an expander, which works in a way similar to a balloon,
is placed instead. Using a tiny valve beneath the skin, the surgeon can inject a salt-water solution into the expander at regular
intervals to fill the expander over time. This can be a process of several weeks until the desired size or volume is achieved.
In the case of Two-Stage Reconstruction, after the skin and muscle over the breast has stretched enough to form a pocket to
accept the implant, a second procedure (on the average 4-6 months later) can be performed to remove the expander and place a
long-term silicone or saline implant into the newly expanded space (also known as the breast pocket).
Breast reconstruction with implants account for approximately 70% of all breast reconstruction procedures. To review some
of the potential advantages and disadvantages of breast implant reconstruction, please refer to the chart.
Potential Advantages | Potential Disadvantages
- Shorter surgery
- Quicker recovery
- Shorter hospital stay
- No donor site complications (such as muscle weakness, pain, bleeding or infection)
- Fewer scars
- May be less painful versus autologous reconstruction
- Avoids a second operative site
- Possibility of multiple surgeries
- Foreign implant in your body
- Higher complication rate – infection and capsular contracture
- Possible differences in size and shape of both breasts
- Breast implants are not permanent
- May require additional revisionary procedures
- Possibility of postoperative pain
Over the last fifty years, surgeons have continually evolved techniques to improve breast reconstruction, beginning with
the Full Muscle Coverage and
Partial Muscle Coverage techniques. In recent
years, many surgeons have turned to biological tissue matrices
because they may provide surgeons with more control in creating the shape and position of the breast.
Plus, biological tissue matrices have many advantages over Full Muscle Coverage and Partial Muscle Coverage techniques.
Review your options carefully and consult with your surgeon to understand what option is right for you.