Breast Cancer Part 4: Reconstruction with Implants

Expander Implant

Choices in Reconstruction

Breast cancer is the most commonly diagnosed cancer in US women. Research has found that breast reconstruction contributes to a woman’s self-esteem and sense of wellbeing; however, over 70% of women eligible for breast reconstruction are not told about all of their options. Breast reconstruction generally falls into two categories: implant reconstruction or reconstruction using a person’s own tissue, also known as autologous reconstruction.

We discussed breast reconstruction with fat transfer and reconstruction with flap techniques in previous blogs. Today we will complete our educational series by discussing implant based reconstruction. No matter what your choice, breast reconstruction is inherently staged. This means it will involve multiple procedures, each being one of the stages, to achieve an optimal outcome.    

Implant Based

A temporary expander, placed under the pectoral muscle, creates a pocket, which will eventually accommodate a permanent silicone or saline implant. This procedure frequently requires an overnight stay in the hospital and has a recovery time of several weeks. Expansion starts a few weeks after the first surgery after the incisions have healed. The expansion process requires multiple office visits and may take anywhere from two months to one year based on the individual needs and desires of the patient. Once the expansion is complete, the expander is exchanged for an implant during an outpatient surgical procedure.  Additional procedures may be required to achieve the desired appearance, shape and symmetry.

Implants are manmade and will eventually fail. Rupture rates are similar for saline and silicone implants and average between 20-25% at 10 years. After 10 years, the rupture rate increases significantly. When a saline filled implant ruptures, your body safely reabsorbs the fluid and the reconstructed breast will flatten as a result. Silicone is a synthetic product and may go undetected when it ruptures. Instead, tissues may become inflamed, causing complications with scar tissue and calcification. When a silicone implant ruptures, it should be replaced promptly. Since silicone ruptures are often silent ruptures, the FDA recommends that women with silicone implants undergo an MRI test three years after having the implants placed and every two years thereafter. This maintenance is an additional personal and financial responsibility for the woman choosing silicone implants.

If you are diagnosed with breast cancer, you have many choices to make so take the time to make the right ones. Immediate reconstruction is safe, but you are not necessarily burning any bridges by delaying your reconstruction for personal reasons. Overcoming breast cancer is a journey and you are not alone. Speak with your primary care physician, breast surgeon and plastic surgeon about your options and help them make the decisions that will give you the best quality of life in the long run. Please click here if you missed Part 1, Part 2, Part 3 of our series.

Photo: Breast Reconstruction with Expander/Implant.

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