The process of breast implantation in women without breasts is a little different than in women with breasts. If a woman has had a mastectomy, a full-size implant might put too much pressure on the skin causing compression of the blood vessels. Without enough blood flow the skin will die. So instead of a regular implant, a tissue expander is placed initially. Think of it as a mini implant. Sterile saline (salt water) is gradually added to the expander until the desired size is reached. This is done in the doctor’s office. A few months later, the patient returns to the operating room, the previous incision is opened, the tissue expander is removed and replaced with the permanent prosthesis.
Mastectomy and placement of a tissue expander takes about 3 hours. Patients stay in the hospital overnight and goes home the next day. With the second operation, when thepermanent implant is placed, patients go home the same day.
There are many different types of implants. Some are filled with saline, some with silicone and some with both. No implant lasts forever. Most patients will need to have them replaced at some point, but this is outpatient surgery and not particularly painful.
Good candidates for implant based reconstruction:
Poor candidates for implant based reconstruction: