Reconstructive Breast Surgery: The Latest Implant Techniques
Breast reconstruction following mastectomy is an integral step in the healing process, and helps tremendously to allow a sense of feeling whole again after surgery. Plastic surgeon Dr. Oren Lerman offers his patients all available reconstructive breast surgery options at our Manhattan practice. It is critical to understand all your options before making your decision to know what is right for you. There are numerous choices for women facing mastectomy or lumpectomy and breast implant reconstruction is one of the most popular. Regardless of your choice for breast reconstruction it is important to understand all of your alternatives. Breast Implant Reconstruction can include numerous benefits, like shorter surgery, minimized scarring and reduced recovery time. To learn more about your options and candidacy for reconstructive surgery, schedule an appointment with us today.
UNDERSTANDING THE PROCESS
Breast implant reconstruction is different from cosmetic breast augmentation. Women undergoing cosmetic breast augmentation have their natural breast tissue in place over the implant protecting it and allowing for a natural shape and feel. After mastectomy, the breast tissue is removed and there is nothing to protect and cover the breast implant other than a thin layer of skin. In order to cover the implant with healthy tissue, improve the feel of the implant and reduce the risk of infection, the implant is placed under the pectoralis muscle. This muscle is closely attached to the underlying chest wall and a space must be created to place the implant. Usually this is done with two stages of surgery spaced three or four months apart. There is also the option to complete a pre-pectoral implant reconstruction, where the implant is placed beneath the skin but over the muscle.
The first operation is done immediately at the time of mastectomy. A special type of breast implant called a tissue expander is placed under the muscle and skin. A tissue expander is like an empty breast implant but is firmer and can be filled with saline solution slowly over the course of a few weeks and months to stretch the overlying skin. Once it is fully expanded and the breast mound has been created, a second surgery is scheduled and we remove the tissue expander and place the final breast implant.
CHOOSING YOUR IMPLANTS
A breast implant can be filled with saline solution or silicone gel. Breast implants come in different sizes and shapes. Your unique health condition and aesthetic goals can help us determine which type of implant is best for you. Both saline and silicone breast implants are safe and effective although silicone implants are more commonly used because they provide a more natural look and feel. The latest generation of silicone breast implants are called Form Stable anatomically shaped implants which have a natural tear drop shape and a firmer consistency. Some people refer to them as “Gummy Bear” implants because of their consistency and feel. Dr. Lerman has extensive experience using these latest generation implants and believes they can achieve a more natural appearing reconstruction and superior results than older implants.
ADVANCED TECHNIQUES FOR IMPROVED HEALING
For patients who are good candidates, we may recommend a single-stage Direct-To-Implant breast reconstruction with acellular dermal matrix or AlloDerm®. This biological mesh or dermal graft acts as an internal bra or sling to help support the implant and add an extra layer of protection under the skin. Additionally, under certain circumstances, this innovative biomaterial allows us to place the final breast implant and reconstruct the breast at the same time as the mastectomy in one single stage without the need for any tissue expansion or second stage surgery.
WEIGHING YOUR TREATMENT OPTIONS
Breast implants have helped millions of women achieve beautiful results. However, some patients may experience complications related to an implant's synthetic material. These complications can include infection, rupture, asymmetry, malposition or capsular contracture. Capsular contracture is one of the most common complication and leads to an abnormal hardening of scar tissue around the implant (capsule). In some women, this capsule of scar tissue can deform the shape of the implant and even be painful. To correct these complications or avoid them altogether, Dr. Lerman may recommend a more natural form of breast reconstruction, such as the DIEP Flap procedure, which utilizes the patient’s own tissue to create a breast mound. Instead of using a breast implant, Dr. Lerman will remove excess skin and fat from the patient’s abdominal area and transplant it to the breast. Since the reconstructed breast is composed of the patient’s own tissue, this technique eliminates the risks associated with saline and silicone breast implants.
LEARN MORE ABOUT CORRECTIVE BREAST SURGERY & DELAYED BREAST RECONSTRUCTION
For patients who have already undergone reconstructive breast surgery, but wish to replace their implants because of a rupture, asymmetry, deformity, capsular contracture (hardening), or unsatisfactory result, there are many options. These can include revising or replacing the breast implants or removing the implants and replacing them all together with natural tissue such as the DIEP flap procedure or another autologous (natural) perforator flap surgery. Many women underwent mastectomy but did not have any reconstruction. In these women a “delayed” breast reconstruction can be performed with many of these same procedures including the more natural DIEP flap surgery. Corrective breast surgery or delayed breast reconstruction sometimes come with their own specific challenges and it is important to seek the advice of a surgeon who specializes in breast reconstruction and microsurgery and can perform all of the many different procedures that might be necessary to correct the problem. To schedule your initial consultation with Dr. Lerman, contact us today.
“The one thing that is most important when we're doing cosmetic surgery and aesthetic surgery of the face or the body is to make sure that the patient is happy afterwards...” Dr. Oren Lerman