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After skin cancer, breast cancer is the leading cancer in women, affecting about one in eight women during their lifetimes. So it should be no surprise that more than 95,000 breast reconstruction procedures are done each year in the US. There are different approaches to breast reconstruction, and placement of a tissue expander is usually the first step. A tissue expander is a device temporarily placed deep on the chest wall to the pectoralis major muscle. This may be done immediately after a mastectomy, or as a later procedure.
The purpose of the expander is to create a soft pocket to hold the permanent implant. Tissue expanders come in a variety of shapes and sizes. During the initial post-mastectomy reconstruction procedure, when it is first positioned on the chest wall, the tissue expander is partly filled with saline. A few weeks later, once the patient has healed, expansion can be started as an office procedure. The expansion process takes place at intervals of one, two, or three weeks, over a period of several months. The expansion can be coordinated with chemotherapy treatments. The amount of fluid placed into the expander during the initial procedure will also determine how many expansions are subsequently required.
Once expansion has been completed and the patient is medically ready for another procedure, the second stage of reconstruction takes place in an outpatient procedure. This involves exchanging the expander for an implant and creating a more refined breast shape. Placement of the initial tissue expander and the subsequent exchange for an implant each take about an hour in the operating room.
Breast Reconstruction Before & After photos
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Selecting Your Implant
You and your surgeon will decide which implant best suits your needs. There are two broad categories of implants: saline-filled implants and the new generation of silicone cohesive gel-filled implants.
Once a patient has had her exchange, she immediately feels more comfortable than she did with the expander. Tightness and discomfort should continue decreasing once the implant has settled and healed. In two or three months, the next stage of surgery is performed to reconstruct the areola of the nipple. If desired, additional contouring procedures (e.g., fat injections) may be performed to adjust the shape of the breast shape in a third stage. In some patients, additional contouring and shaping may be necessary. For patients who need one breast reconstructed, it is common to perform an adjustment procedure on the opposite breast (e.g., augmentation, reduction, or lift) for better symmetry. For patients having both breasts reconstructed, it is easier to achieve symmetry using implants.
Tissue expansion with delayed permanent silicone implant placement is a popular method of breast reconstruction due to its relatively less invasiveness, advances in implant quality and variety, and better preservation of sensation. Of course, tissue expansion may not be feasible for all women, especially those who are undergoing radiation therapy. Furthermore, in some cases, implants are not well accepted by the host body. Autologous tissue transplantation is the alternative of choice for breast reconstruction. In this approach, the woman’s own tissue (usually taken from the lower abdomen) is used to form the new breast. Autologous reconstruction is a more invasive procedure due to the second surgical site, but it looks and feels natural, and there is no reaction to the implant.
With recent advances in science and technology, increasing numbers of women diagnosed with breast cancer in its early stages, and breast cancer survival is thus increasing. And these new developments are not limited to early detection and treatment of breast cancer but apply to breast reconstruction as well. The relief and happiness of being cured of your breast cancer now can be enhanced by getting your breast back through reconstructive surgery.
Schedule Your Consultation
Dr. Ceydeli and Dr. Duong are highly-trained plastic surgeons who have done countless breast reconstruction surgeries. If you’re interested in setting up a consultation, please contact us today. We look forward to beginning this journey with you and are here to answer any questions.
Video of Dr. Ceydeli Discussing Breast Reconstruction
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Panama City, Florida