Two different types of prostheses are used for reconstruction of the breast with an implant:
- Tissue expanders placed for a temporary period
- Permanent fixed-volume breast implants
Tissue expanders are used to give the breast skin elasticity before the permanent prosthesis is placed. They are temporarily inflated by injecting progressively increasing amounts of saline into the chamber inside them. When the time comes they are removed and a permanent implant is placed in their place, or it is possible to leave some special types of tissue expanders in place like a permanent implant.
Fixed-volume permanent implants are generally silicone-based products. Silicone prostheses that are usually gel-filled and have a textured surface are used.
The use of only a synthetic implant for reconstruction is preferred by patients who do not want surgery on their back or abdomen.
Reconstruction with synthetic implants is not a good option for those who have received radiotherapy to the chest wall or who have a high likelihood of receiving radiotherapy after the operation.
In reconstruction procedures performed with either a tissue expander or a permanent implant, the prosthesis is placed under the muscles of the front chest wall.
Who Is Suitable for a Silicone Breast Prosthesis?
- If the patient’s own body tissue suitable for breast reconstruction is not available,
- If the breast tissue area is not badly scarred or infected,
- If a prophylactic (protective) mastectomy has been performed,
- If bilateral breast reconstruction is being performed,
- If the patient has allowed surgery on the other breast to achieve symmetry,
- If she has not received radiotherapy to the breast or chest wall; she is an ideal candidate for breast reconstruction with a silicone breast prosthesis.
Reconstruction with a Breast Implant in a Single Session
The breast containing cancer is removed while preserving the breast skin and, if possible, the nipple. In the same session a breast prosthesis is placed under the pectoral muscle. This method is generally preferred in those with early-stage cancer and whose healthy breast is small. Sometimes people carrying a breast cancer gene may also prefer this procedure by having their breasts removed before cancer develops.
Reconstruction with a Breast Implant in Two Sessions
In cases where the breast tissue is removed together with the skin, the remaining skin may not provide enough space to place the implant. In this case a half-gel, half-empty prosthesis is placed in the area. This prosthesis is slowly inflated with saline within 2 to 3 months. When it is judged that the skin in this area provides enough laxity, the temporary prosthesis is removed. A permanent gel implant is placed in its place. Sometimes, while the temporary implant is in place, time is gained for additional treatments such as radiotherapy.
