In breast implant based reconstruction, an implant is used to recreate shape, volume and symmetry in your breast(s). Breast reconstruction using an implant can be accomplished through one of two types of staged breast reconstruction: in a direct-to-implant reconstruction (also known as a "one-stage reconstruction"), or in a tissue expander-to-implant reconstruction (known as a "two-stage reconstruction").
In some cases, there is enough tissue left after mastectomy to insert the implant (filled with silicone or saline) directly beneath the skin and muscle without having to expand the breast pocket with an expander. If there isn't enough tissue after mastectomy, a tissue matrix may be used to help with this type of procedure because a tissue matrix acts as a supplement for existing tissue. The benefit of one-stage breast reconstruction is that the patient may not need a second surgery for the expander-to-implant exchange. This is also known as a direct-to-implant reconstruction. It is important to note that one-stage reconstruction is only done in approximately 6-14% of breast implant reconstruction procedures.1 There are specific parameters to be a good candidate for one-stage reconstruction so be sure to have a discussion with your surgeon.
Alternatively, tissue expander-to-implant or two-stage Reconstruction is the most common type of breast implant reconstruction performed. In tissue expander-to-implant rreconstruction, an expander, which works in a similar way to a balloon, is placed beneath the skin and chest muscle. Using a tiny valve beneath the skin, the surgeon injects a salt-water solution into the expander at regular intervals to fill the expander over time (this can be a process of several months until the desired expansion is achieved).
After the skin and muscle over the breast have stretched enough to form a pocket to house the implant, a second procedure (on average 4-6 months later) removes the expander and places a permanent silicone or saline implant into the newly expanded space (also known as the breast pocket). Talk to your surgeon for more details on these options.
1 Millennium Research Group Market Tracking Study October 2009.