Breast reconstruction - implants

Definition

After a mastectomy, some women choose to have surgery to remake their breast. This type of surgery is called breast reconstruction. It can be performed at the same time as mastectomy (immediate reconstruction) or later (delayed reconstruction).

The breast is usually reshaped in two stages, or surgeries. During the first stage, a tissue expander is used. An implant is placed during the second stage. Sometimes, the implant is inserted in the first stage.

Alternative Names

Breast implants surgery; Mastectomy - breast reconstruction with implants; Breast cancer - breast reconstruction with implants

Description

If you are having reconstruction at the same time as your mastectomy, your surgeon may do either of the following:

In either case, skin is left to make reconstruction easier.

If you will have breast reconstruction later, your surgeon will remove enough skin over your breast during the mastectomy to be able to close the skin flaps and make the chest look as smooth and flat as possible.

Breast reconstruction with implants is usually done in two stages, or surgeries. During the surgeries, you will receive general anesthesia. This is medicine that keeps you asleep and pain-free.

In the first stage:

In the second stage:

You may have another minor procedure later that remakes the nipple and areola area.

Why the Procedure Is Performed

You and your surgeon will decide together about whether to have breast reconstruction, and when to have it.

Having breast reconstruction does not make it harder to find a tumor if your breast cancer comes back.

Getting breast implants does not take as long as breast reconstruction that uses your own tissue. You will also have fewer scars. But, the size, fullness, and shape of the new breasts are more natural with reconstruction that uses your own tissue.

Many women choose not to have breast reconstruction or implants. They may use a prosthesis (an artificial breast) in their bra that gives them a natural shape, or they may choose to use nothing at all.

Risks

Risks of anesthesia and surgery in general are:

Risks of breast reconstruction with implants are:

Before the Procedure

Tell your surgeon if you are taking any medicines including supplements, or herbs you bought without a prescription.

During the week before your surgery:

On the day of your surgery:

After the Procedure

You may be able to go home the same day as the surgery. Or, you will need to stay in the hospital overnight.

You may still have drains in your chest when you go home. Your surgeon will remove them later during an office visit. You may have pain around your cuts after surgery. Follow instructions about taking pain medicine.

Fluid may collect under the incision. This is called a seroma. It is fairly common. A seroma may go away on its own. If it does not go away, it may need to be drained by the surgeon during an office visit.

Outlook (Prognosis)

Results of this surgery are usually very good. It is nearly impossible to make a reconstructed breast look exactly the same as the remaining natural breast. You may need more "touch up" procedures to get the result you want.

Reconstruction will not restore normal sensation to the breast or the new nipple.

Having breast reconstruction surgery�after breast cancer can improve your sense of well-being and your quality of life.

References

Boukovalas S, Kalaria SS, Park JE. Breast reconstruction. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 36.

Cameron J. Breast. In: Cameron J, ed. Current Surgical Therapy. 14th ed. Philadelphia, PA: Elsevier; 2023:717-808.


Review Date: 3/11/2023
Reviewed By: Debra G. Wechter, MD, FACS, General Surgery Practice Specializing in Breast Cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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