Breast reconstruction with implants
To reconstruct the breast size, when the skin is of good tone the easiest method is to use a prosthesis.
Since January 2001, the prostheses used are anatomical silicone gel implants, broad-based and tailored to the size of the opposite breast.
The implants available in the market, both in the projection of their base and height, currently allows them to better adapt to the size of the opposite breast.
These implants are ideally positioned behind the pectoralis major muscle.
Before breast reconstruction Multifocal ductal left breast cancer
After immediate breast reconstruction with silicone gel implant.
After breast reconstruction Reconstruction of the areola and nipple graft. Outcome at 3 months.
To put it in place, we always use the outer part of the mastectomy scar. The procedure usually lasts an hour.
A short-term drain is placed to prevent the formation of a hematoma. Hospitalization lasts 2 to 3 days.
The postoperative pain lasting several weeks due to the submuscular position of the prosthesis, fades gradually with the help of painkillers.
A bra and a bandage is prescribed for a month to maintain the ideal position of the implant and prevent displacement during contraction of the pectoralis major.
Previous radiotherapy is not against the introduction of an implant if the skin is of good tone.
Before breast reconstruction
No radiotherapy.
Mastectomy scar supple.
After breast reconstruction with silicone gel implant. Outcome at 1 month. Use of existing scar.
After breast reconstruction Final result. Reconstruction of the areola and nipple. Breast reduction on the right. Outcome at 3 months
A period of six months to a year after the end of radiotherapy is considered reasonable before reconstruction.
Postoperative retraction of the prosthetic may occur within an unforeseeable range of a month or 5 to 10 years after surgery.
When retraction is significant the reconstructed breast becomes hard, spherical or painful.
This retraction is troublesome in 20-30% of cases, and may justify further surgery with capsulotomy and possibly a change of implant.
Textured implants, used in breast reconstruction seem to decrease the number of shells.
Implant breaks have become rare since the casings of implants are thicker and the gels used are more cohesive.
In case of rupture of an implant of strong cohesiveness, the silicone remains in situ and does not diffuse out of the reconstructed breast.
After the introduction of an implant, an internal dimple can be seen during contraction of the pectoralis major muscle.
This internal dimple can be avoided by keeping the innermost fibers of the pectoralis major.
The introduction of a prosthesis is the most simple and most frequently performed breast reconstruction.
It requires thorough pre-operative information, regular clinical and radiological follow ups, and the patient is informed that the prostheses are never final and must be reasonably replaced after a period of 12 to 15 years.
Before breast reconstruction Breast cancer recurrence widespread left. Indication of reconstruction
After immediate breast reconstruction with anatomical silicone gel prosthesis. Outcome at 3 months.
After breast reconstruction with prosthesis. Outcome at 6 months of the right breast reduction and reconstruction of the left areola.
Before breast reconstruction No radiation, soft-sided
After breast reconstruction with anatomical silicone gel prosthesis.
Outcome at 3 months.
After breast reconstruction with prosthesis. Final outcome at 3 months with reconstruction of the nipple and areola and also vertical mammaplasty of the left breast.
After breast reconstruction Final outcome at 6 months.