What is the Breast Implant Reconstruction Procedure?

Frequently Asked Questions

One-Stage Immediate Breast Implant Reconstruction

Immediate one-stage breast reconstruction may be done at the time of your mastectomy. After the general surgeon removes your breast tissue, the plastic surgeon will then implant a breast implant that completes the one-stage reconstruction. In reconstruction following mastectomy, a breast implant is most often placed submuscularly.

Two-Stage (Immediate or Delayed) Breast Implant Reconstruction

Breast reconstruction usually occurs as a two-stage procedure, starting with the placement of a breast tissue expander, which is replaced several months later with a breast implant. The tissue expander placement may be done immediately, at the time of your mastectomy, or be delayed until months or years later.

Stage 1: Tissue Expansion

During a mastectomy, the general surgeon removes skin as well as breast tissue, leaving the chest tissues flat and tight. To create a breast-shaped space for the breast implant, a tissue expander is placed under the remaining chest tissues.

The tissue expander is a balloon-like device made from elastic silicone rubber.

It is inserted unfilled, and over time, sterile saline fluid is added by inserting a small needle through the skin to the filling port of the device. As the tissue expander fills, the tissues over the expander begin to stretch, similar to the gradual expansion of a woman’s abdomen during pregnancy. The tissue expander creates a new breast-shaped pocket for a breast implant.

Tissue expander placement usually occurs under general anesthesia in an operating room. Operative time is generally 1 to 2 hours. The procedure may require a brief hospital stay, or be done on an outpatient basis. Typically, you can resume normal daily activity after 2 to 3 weeks.

Because the chest skin is usually numb from the mastectomy surgery, it is possible that you may not experience pain from the placement of the tissue expander. However, you may experience feelings of pressure, tightness, and discomfort after each filling of the expander, which subsides as the tissue expands but may last for a week or more. Tissue expansion typically lasts 4 to 6 months.

Stage 2: Placing the Breast Implant

After the tissue expander is removed, the unfilled breast implant is placed in the pocket, and then filled with sterile saline fluid. In reconstruction following mastectomy, a breast implant is most often placed submuscularly. The surgery to replace the tissue expander with a breast implant (implant exchange) is usually done under general anesthesia in an operating room. It may require a brief hospital stay or be done on an outpatient basis.