Breast Reconstruction with Implants
Breast reconstruction with implants constitutes the simplest technique to reconstruct a breast.
Supple and well vascularized skin is a necessary pre-condition for this procedure. If a mastectomy has been performed, the existing scar will be used in order to avoid additional scars. In the case of breast abnormalities, the scar will be placed in the bottom fold of the breast or, in some cases, in the areola area.
Before the procedure
Before the surgery, physiotherapy will be prescribed in order to prepare and to soften the skin, especially if radiation therapy has been administered to the patient previously. Massage can be executed alone or with the help of a physiotherapist.
It is customary to wait a year after completion of radiotherapy before starting reconstruction, the time for the skin to heal after the treatment.
It is necessary to stop smoking a month before and a month after the surgery to ensure optimum healing as contrary to cosmetic breast augmentation for which there is skin and the mammary gland in front of the implant, in the case of breast reconstruction with an implant, the implant is much closer to the skin and the risk of exposure is greater (leading to the removal of the breast implant).
The procedure
The surgery is performed under general anesthesia, lasts between 1 and 2 hours, and the patient will be hospitalized for 3 or 4 nights after the surgery. Because of its anatomical shape (waterdrop shape), the implant offers an aspect which appears as natural as possible.
The implant is positioned behind the pectoral muscle in order to put as much tissue as possible in front of the implant.
In some cases, a temporary tissue expansion prosthesis is performed in order to increase the covering tissue quality (skin, muscles) which can be used before placing the permanent implant in order to give the reconstructed breast a more natural appearance. If that is done, the surgeon will continue to inflate the prosthesis each week in her office in Paris.
After the procedure
Drains will be left in place in order to avoid bruising and they will be removed between the 2nd and the 4th day. The initial bandage is generally removed the day following the surgery and will be replaced with a medical front-fastening bra, which is to be worn day and night during the first month following surgery.
The distension of the pectoralis major muscle may cause significant pain in the days following the procedure, but it is always treated preventively and accordingly to the patient’s needs.
Postoperative physiotherapy with massages and rehabilitation of the upper limb may be prescribed in order to speed up recovery.
The definitive result will start to appear and be visible 3 to 6 months post surgery.
Symmetrizing the contra lateral breast, breast ptosis, breast reduction or breast augmentation, and reconstructing the areola and the nipple.
Several months later, a second intervention, or even a third one, may be necessary in order to symmetrize the contralateral breast and to reconstruct the areola and the nipple.
The first shower is permitted the day after the surgery but baths should be avoided for the first month. The scars need to be protected from the sun for 1 year following surgery!
Sport can be gradually resumed approximately 6 weeks after breast reconstruction with an implant. However, jogging is forbidden for 3 months to limit the risk of post-operative rotation of the implant
