Reconstruction methods
Implant reconstruction is usually a process rather than a one-time device placement.
Implant-based reconstruction may use a tissue expander followed by a permanent implant or, in selected patients, placement of an implant during the mastectomy operation.
Eligibility depends on the condition of the skin, breast anatomy, cancer-treatment plan and surgeon assessment.
Tissue expander reconstruction
A tissue expander is a temporary adjustable device. It can be gradually filled after surgery to create space for a later implant.
The expansion process requires follow-up visits. A second operation is generally required to exchange the expander for a permanent implant.
Direct-to-implant reconstruction
Direct-to-implant reconstruction places a permanent implant during the mastectomy operation.
It may avoid an expansion stage in appropriately selected patients. However, the final implant size and position depend on the mastectomy skin, blood supply and intraoperative findings.
Potential complications
- Infection
- Skin or nipple necrosis
- Fluid collection
- Bleeding
- Wound separation
- Implant exposure
- Implant loss
- Capsular contracture
- Rippling or visible implant edges
- Implant displacement
- Asymmetry
- Need for revision or replacement
Implants and radiotherapy
Radiotherapy may increase the risk of hardening, distortion, pain and implant-related reconstruction failure.
This does not mean that implant reconstruction is never used when radiotherapy is possible. It means that the timing, staging and alternatives require careful discussion.
Long-term considerations
A breast implant is not a lifetime device.
Even without an early complication, future imaging, revision, exchange or removal may be required. Patients returning to another country should establish who will monitor the reconstruction and how implant-related concerns will be assessed.