What is implant-based reconstruction?
Following mastectomy (by your Oncological Surgeon), an implant-based breast reconstruction is performed by a plastic surgeon in order to restore the natural shape of the breast. The reconstruction can be done at the time of your mastectomy, in which case the procedure is known as an immediate reconstruction, or it can be performed at a later stage as a delayed (or staged) reconstruction. Either an expander or a silicone-based implant is used for this purpose.
What does the procedure involve?
Various factors will be taken into account before the procedure can take place. These include your overall health, your age, the extent of your disease, the need and timing of nipple-areolar reconstruction, and whether or not you will have chemo-or radiation therapy.
A tissue expander comes into play when there's not enough skin (after the mastectomy) to cover an implant, or when there's a need to delay the actual prostheses placement (e.g. radiation). Dr van den Bergh will place this balloon-shaped tissue expander under the pectoral muscle/ skin at the time of your mastectomy, or as a delayed procedure. The balloon will be filled with a saline solution by means of slowly and gradually inflating the expander, allowing the skin to stretch. The tissue expander will be filled with saline every one or two weeks (through an injection port) until the tissue has stretched sufficiently.
When your skin has stretched enough, Dr van den Bergh will perform a second surgery in which the tissue expander is removed. A permanent implant will then be placed. Although there may now be enough skin to cover the implant, there might be a need to recruit more of your own tissue (or synthetic alternatives) to add durable cover for the permanent implant.
Who is a suitable candidate for implant-based reconstruction?
Implant-based reconstruction following mastectomy is often an effective option for women who would like to avoid the need for an external prosthesis and where using the body's own tissue would be insufficient or contra-indicated. Dr van den Bergh will discuss the indications, contra-indications, the possible complications and future implication for this type of reconstruction with you in detail.