Implant reconstruction: what to expect

Depending on the amount of tissue you have available after your breast surgeon has removed the breast tissue, your plastic surgeon will either insert the implant directly, or place a tissue expander under your chest muscle in order to stretch the skin over time to make room for the final implant.

Types-of-BR-implantsMastectomy surgery can take 2 to 3 hours to complete. If you’re having an implant or tissue expander inserted at the same time, this will take about another hour or so. If you’re having implant surgery some time after mastectomy and other treatments (delayed reconstruction), surgery to insert the tissue expander may be done about 4 to 6 months after your last treatment.

In order to stretch the skin, saline will gradually be injected into the tissue expander over the course of a few months. Once the skin stretching is completed, you’ll most likely have more surgery to replace the tissue expander with a permanent implant. Surgery is usually scheduled about 4 to 6 weeks after the last amount of liquid has been added to the expander. Surgery to insert the permanent implant takes about an hour.
In some cases, your surgeon may use a permanent expander. This device doubles as an expander and an implant. When the stretching is done, the device is filled with the correct amount of saline and the port is removed.

If radiation therapy is part of your treatment plan, some surgeons prefer that the radiation happen while you still have the tissue expander. These surgeons believe this approach offers a better cosmetic result because it offers an opportunity to remove any radiation scar tissue before placing the final implant. Other surgeons feel that radiation over the permanent implant doesn’t pose a cosmetic risk. If you’re not sure which option is right for you, it’s a good idea to seek a second opinion with another plastic surgeon who specializes in breast reconstruction.

AFTER IMPLANT RECONSTRUCTION SURGERY

It can take about 6 weeks to recover from implant surgery done at the same time as mastectomy. It’s important to take the time you need to heal. It’s also important to continue doing your arm exercises each day and follow any other routines your doctor or physical therapist prescribes for you.

When you have surgery to swap the tissue expander for a permanent implant (the second step of delayed-immediate or delayed reconstruction), it’s usually done as an outpatient procedure, which means you don’t stay overnight in the hospital. You’ll still be given general anesthesia, so you’ll need to have someone come with you to the hospital or clinic to drive you home. This surgery takes about an hour. Because this surgery is less involved than the mastectomy-tissue expander/implant surgery, recovery usually takes about 2 weeks.