Implant Breast Reconstruction

Reconstruction with implants

An implant can rebuild a breast. It cannot rebuild one the skin will not hold.

The approach

Expanders and implants

Implant reconstruction places a breast implant under the skin that remains after mastectomy, sometimes under muscle. When the skin is too tight on the day of the cancer operation, a tissue expander is placed first and filled over later visits until there is room for the permanent implant.

This path fits a woman whose skin flaps are healthy, who may not want a longer tissue-flap operation, and who accepts that an implant is a device with a lifespan. Rupture screening still applies later. See MRI and ultrasound.

Radiation makes implant reconstruction harder. Capsular contracture is more common, and the skin may be too tight or too thin. In that situation an implant may be the wrong tool, and your own tissue is discussed instead. Dr. Sayah and Dr. Funk make that call together, before a device is ordered.

This is general information about how these questions are usually approached. It is not a diagnosis, and it does not replace a visit. Screening and treatment are planned for one person at a time.

The course of an implant reconstruction

When the skin flaps after mastectomy are reliable, an implant can go in on the same day, above or below the muscle, with or without a sling of material to support the lower pole. When the skin is tight or the blood supply is uncertain, a tissue expander is placed instead and filled gradually in the office until the permanent implant fits. That second operation is shorter than the first. It is still an operation.

You keep the implant surveillance schedule afterward. Silicone gel implants need periodic ultrasound or MRI. A firm, high, or painful breast later is evaluated for contracture. Radiation after an implant raises that risk enough that many radiated chests are better served by your own tissue. If radiation is already in the plan, say so before the device is ordered.

Dr. Sayah and Dr. Funk decide together whether direct-to-implant, an expander, or no implant is the right first step. The matching procedure on the other breast, if you want one, is quoted and scheduled as part of the same plan rather than discovered later.

Common questions

Frequently asked questions

How long does an implant last?

Implants are not lifetime devices. FDA labeling recommends periodic imaging for silicone gel implants, and any change in shape or comfort is a reason to be seen.

Can the implant go in the day of the mastectomy?

Direct-to-implant reconstruction is possible when the skin flaps are reliable. If they are not, an expander or a delayed plan is safer.

Get started

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