Breast reconstruction with implants

This operation aims at restoring breast volume and reconstructing breast shape with an implant. It is the most simple technique and doe not imply additional scars. It can be used only if the skin is soft and well vascularized. Physical therapy after surgery is highly recommended and stop smoking is mandatory. Otherwise, the implant needs to be associated with a flap or an autologous flap needs to be created, such as a DIEP flap.

The different types of implants

Implants are made of a high density silicone gel inside an envelope of silicone. Their safety is well established. The implant may be round or anatomical (teardrop shape) and its surface is textured, irregular and rough to reduce risks of displacement. In some cases, a temporary tissue expansion implant is placed before the permanent implant to increase the quantity of the covering tissues (skin, muscle) and give a more natural appearance to the reconstructed breast.

Before the procedure

It is recommended to stop smoking one month before and one month after the surgery (smoking can delay healing).
No aspirin-based medication should be taken during the 10 days preceding the operation.

The procedure

The procedure is performed under general anaesthesia and lasts between 1 and 2 hours. The mastectomy scar is opened to avoid creating an additional scar.
The implant is introduced in a cavity created under the greater pectoral muscle, against the rib bones. A drain sucks up post-operation secretions and reduces the risk for bruising.

After the procedure

In view of the distension of the greater pectoral muscle by the implant, pain can be important during the first days after surgery. It is systematically preventively treated and adapted to your case. Every surgery can imply risks and complications. The first bandage is usually removed the day after the surgery and replaced by a sport bra without armature and with a front opening. You will be asked to wear a pressure garment (a type of belt pressing on the superior part of the breasts) for the implant not to move upward. The bra and the pressure garment need to be bought before the operation and to be worn day and night during at least one month. The drain is removed if necessary between the 2nd and the 8th day after surgery, but you can return home from the 2nd day after the operation if your state makes it possible, even with the drain. It will be removed during a consultation. Cutaneous expansion: If a cutaneous expansion system is placed, pain is minor and wearing the bra is not essential. It will be needed for the second surgery session.

The result

The volume of the reconstructed breast is firm, not too mobile and the appearance is youthful. A second operation may be necessary after a few months for a better symmetry of the contralateral breast and to reconstruct the areola and the nipple.