Breast Implant
Implant Reconstruction
Introduction
Implants are made from silicone enveloped and filled with either silicone gel and saltwater solution (saline). Saline implants are rarely used these days due its instability and high risk of rupture.
Silicone implant vs Saline implant
Implant reconstruction are preferably recommended for women in very early stage of breast cancer who do not need radiotherapy or chemotherapy as both these therapies can affect the outcome and enhance the complications and risks.
Bilateral Breast DCIS – bilateral immediate implant reconstruction
Commonly used for breast augmentation are silicone implants and they come in various sizes and shapes. They can be operated as a single stage surgery (immediately after breast cancer removal) or as a delayed stage (after insertion of implant expander). In some difficult cases in order to achieve ideal cosmetic result, several corrective surgeries may be necessary.
Post Mastectomy Delayed Implant Insertion
Advantages
- Shorter operating hours and hospital stay
- Smaller scar and incision
- Shorter recovery time and earlier return to daily activities.
- Rebuild a breast without affecting other parts of the body
Disadvantages
- Capsular contracture : scar tissue forms around the implant creating a false capsule that can harden. In severe cases, it can be painful and distort the shape of the breasts. Radiation therapy can result in capsular contracture.
- Skin Necrosis : The skin can be thinned out after breast surgery and the insertion of implant could increase the pressure within and results in protrusion of the breast implant.
- 2 or more operations may be necessary in order to achieve the expected size and shapre
- Risk of breast anaplastic large-cell lymphoma (ALCL) in women eith textured breast implant. Risk is relatively low but FDA recommends regular monitoring of the symptoms of ALCL. Further information can be read here : https://www.breastcancer.org/research-news/study-estimates-risk-of-rare-cancer-from-implants
- Distortion with movement : the implant may move or distort when pectoralis muscles contract or skin is too thin result in significant imbalance.
- Implant ruptures / leak : more common in saline implant
- Does not last a lifetime – may need replacement after 10-15 years.
Immediate Implant Reconstruction (without tissue expander)
Implant can be inserted immediately and directly after mastectomy. This is depends on the size of the breast and implant and muscle and tissue pliability.
Delayed Implant reconstruction with tissue expander
After mastectomy, if there is not enough room to fit an implant of the desired size, then a temporary inflatable tissue expander will be inserted first to gradually stretch the skin over time. The tissue expander is like a balloon bag that is injected with saline over time to slowly stretch the skin to the desireed size before an actualy silicone implant is inserted.
Source: www.cancercouncil.com.au
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