Breast Implant Reconstruction
One of the simplest techniques used in breast reconstruction is to use an implant only. This is a great option for women who will not require radiation therapy or have not had radiation therapy in the past. This procedure is also ideal if home or work demands mean that you need to have the shortest downtime possible after surgery.
What's involved in the procedure?
An implant-only breast reconstruction recreates your breast shape using a silicone implant, avoiding any of the secondary scars on your body associated with more complex tissue transfer procedures. This type of procedure can be done in one stage (when the silicone implant is placed under your skin at the same time as your mastectomy), or in two stages (when a tissue expander is first inserted under your skin and then replaced by a permanent silicone implant at a later stage). A tissue expander is essentially a salt-water balloon with a silicone shell that can be slowly inflated over several weeks. The role of this tissue expander is to stretch out your remaining breast skin to compensate for any skin removed during your mastectomy.
Reconstruction of your breast using an implant or expander is performed under general anaesthesia with a one night stay in hospital. Mr Ghattaura typically gains access to the breast by removing the old mastectomy scar if this is a delayed reconstruction or by using the incision made my the breast cancer surgeon during an immediate reconstruction. He then designs a suitable pocket for the implant, normally under your main chest wall muscle. He then carefully chooses the right implant and place this into the pocket, before closing the skin with dissolvable stitches and applying appropriate dressings.
Time to recover
After your surgery, you will need to wear a support bra for 6 weeks to maintain the new implant position. You can expect some swelling, bruising, and some soreness for the first few weeks. Oral pain medication can be used to alleviate side effects, which should begin to resolve quickly. The scar is often red and raised initially, but should fade as your body heals. Typically, patients recover for about a week at home before returning to work and resuming normal activities. Exercise and strenuous activity is to be avoided for at least a 4-6 weeks following surgery.
If you have an expander implant, you will need to return to clinic after 2-3 weeks to have salt-water added to the implant through a small needle in your chest skin. During this clinic appointment, you will notice your breast volume expands and your skin starts to stretch. Although, your breast starts to feel very tight straight away, this normally resolves over the following week. This process may need to be repeated on multiple occasions until the necessary volume is achieved. At this stage, you will be booked for your seconds stage procedure to exchange your salt-water expander implant for a permanent silicone implant.
Although breast implant reconstruction is a relatively quick and safe procedure, there are some downsides to consider. The final breast can feel quite firm compared to your natural breast and an implant only breast reconstruction does not move like a normal breast. In addition, it is likely that you will need a revision in the years to come as the tissues around the implant age.
Available at HMT Sancta Maria, Spire Cardiff Hospital and Nuffield Health