Breast reconstruction - implants

Alternative Names: Breast implants surgery

After a mastectomy, some women choose to have cosmetic surgery to recreate their breast. This surgery can be performed during mastectomy itself or later.

The breast is usually reshaped in two stages. First a tissue expander is used. Then a saline implant is placed. Sometimes the implant can be inserted in the first stage.

Description of Procedure

If you are having reconstruction at the same time as your mastectomy, your surgeon may do a skin sparing mastectomy. This means only the area around your nipple and areola is removed and more skin is left to make reconstruction easier.

If you will have breast reconstruction later, your surgeon will remove enough skin over your breast during the mastectomy to be able to close the skin flaps.

Breast reconstruction with implants is usually done in 2 stages. You will receive general anesthesia (asleep and pain-free).

In the first stage:

• Your surgeon will place a small tissue expander under your chest muscle and skin. The expander is a pouch made out of silicone, similar to a balloon.
• Your chest will still look flat right after this surgery.
• Starting about 2 - 3 weeks after surgery, you will see your surgeon every 1 or 2 weeks. During these visits, your surgeon will inject a small amount of saline (salt water) through your skin into the pouch through a valve.
• The pouch or tissue expander slowly enlarges the pouch in your chest to the right size for the surgeon to place an implant.
• When it reaches the right size, you will wait 1 - 3 months before the permanent breast implant is placed (the second stage).

In the second stage:

• Your surgeon will remove the tissue expander from your chest and replace it with a breast implant. This surgery takes 1 - 2 hours.
• Before this surgery, you will have talked with your surgeon about the different kinds of breast implants. Implants may be filled with either saline or a silicone gel.

You may have another minor procedure later that remakes the nipple and areola area.

Risks of Breast reconstruction - implants

Risks for any surgery are:

• Blood clots in the legs that may travel to the lungs
• Blood loss
• Breathing problems
• Heart attack or stroke during surgery
• Infection, including in the surgical wound, lungs (pneumonia), bladder, or kidney
• Reactions to medicines

The risks for breast reconstruction with implants are:

• The implant in 1 out of every 10 women will break or leak in the first 10 years. If this happens, you will need more surgery.
• A scar may form around the implant in your breast. If the scar becomes tight, your breast may feel hard and you may have pain or discomfort. This is called capsular contracture. You will need more surgery if this happens.
• Infection soon after surgery. You would need to have the expander or the implant removed.
• Breast implants can shift. This will cause a change in the shape of your breast.
• One breast may be larger than the other (asymmetry of the breasts).
• You may have a loss of sensation around the nipple and areola.

Review Date: 1/26/2011
Reviewed By: Shabir Bhimji, MD, PhD, Specializing in General Surgery, Cardiothoracic and Vascular Surgery, Midland, TX. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

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