Quickly Restore Contours with Immediate Breast Reconstruction

The Procedure

Once the mastectomy is complete, the procedure, also called one-stage reconstruction, will be performed immediately. For immediate placement, the reconstructive surgeon uses a permanent implant that can be adjusted after the operation. The adjustable implant is filled with saline inside a silicone shell. (Silicone breast implants are not usually used for immediate breast reconstruction.) The implant is placed over the chest muscle and filled about three-quarters of the way with sterile saline. Filling the implant only partially allows the skin to heal smoothly without tension and reduces the chance of complications. The implant is connected to a port under the skin that allows it to be filled with more saline in Dr. Lerman’s office following the procedure. Typically, only one or two inflations are all that is needed to achieve a uniform appearance, and then the port is removed.

Benefits of an Immediate Reconstruction

For years there was a misconception that a reconstructive surgery had to be scheduled months following a mastectomy. However, due to advanced techniques, patients can now undergo the procedure on the same day with positive results. Patients can experience several benefits by immediately undergoing reconstruction. Some advantages, when compared to a delayed procedure, may include a shorter recovery time, lower cost, a more natural appearance, and less visible scarring. When a woman has a mastectomy without reconstruction, the surgeon removes most of the breast skin through an incision across her chest, which leaves a long scar. If she undergoes reconstruction sometime later, the surgeon will reopen this mastectomy scar to perform the surgery. The scar will remain on the reconstructed breast, but will fade somewhat over time. With immediate reconstruction, the surgeon can often hide the mastectomy incisions  in the inframammary fold under the breast, or around the areola. Essentially, you enter immediate reconstruction without visible scars on your breast, and emerge from surgery the same way. Bear in mind, however, that flap reconstruction will leave a scar at the donor site. However, these scars are generally hidden by bathing suits or undergarments, and they should become less noticeable over time. In addition to these aesthetic benefits, many patients will experience significant psychological benefits, since they do not have to wait months for their follow-up procedure to see results of the surgery. 

Candidates

During your consultation, your medical status and history will be evaluated to determine whether you are a good candidate for immediate reconstruction. Unless there is a specific cancer-related reason to remove the nipple and areola, most women today have nipple-sparing mastectomy. The mastectomy surgeon removes the entire contents of the breast through an incision in the natural fold under the breast. This technique preserves all of the breast skin in addition to the nipple and areolar complex, which allows an implant to be placed immediately without the need for tissue expansion and a second reconstructive procedure to create a new nipple-areolar complex. 

Some of the factors that may determine your candidacy include:

• Size of Tumor: Patients with a smaller tumor have an increased probability of being a suitable candidate.
• Tumor Placement: A non-invasive tumor that is not directly beneath the nipple or areola will increase the likelihood of your candidacy.
• Family History: If you carry the BRCA gene and are undergoing a preventative mastectomy, you may be a good candidate.

Some of the factors that may rule out the candidacy for the procedure may include patients who:

• Smoke
• Have poorly controlled diabetes
• Have rapidly growing tumors
• Experience multiple medical concerns and issues
• Require radiation therapy after their mastectomy

Find out If This Procedure Is Right for You

During this difficult time, we will help each patient  find a solution that will help them recover both mentally and physically as quickly as possible. If you are considering a post-operative procedure to restore your bust and would like to know whether an immediate reconstruction is your best option, please contact us to set up a consultation.