Patients who wish to restore their breasts to a specific size and shape are good candidates for implant-based breast reconstruction. Breast reconstruction fat grafting and flap techniques can create beautiful feminine contours, but these methods do have limitations as to the volume that can be added to the breasts. Breast implants, on the other hand, offer the surgeon more control over the final size and shape of the breasts. As a result, many breast reconstruction patients opt to undergo implant-based methods to re-create the breast mound.
Bay Area Plastic Surgeon John R. Griffin is experienced in the many implant-based approaches that can be performed on patients. He will work with the patient, and the patient’s oncologist and breast surgeon, to determine if a one-step or staged procedure is best suited to the patient’s particular needs. If only one breast requires reconstruction, he can develop a treatment plan for the other breast to ensure that good symmetry is achieved.
Candidates
The best candidates for breast reconstruction using implants are those who:
- Do not have a sufficient amount of tissue to undergo flap techniques
- Do not have an adequate amount of excess fat to undergo fat grafting techniques
- Have enough skin to create a pocket for the implant
Patients who do not have adequate skin are better suited to staged breast reconstruction, in which a tissue expander is placed in the breast pocket for one or two months prior to placement of the implant.
Good candidates for a one-step implant-based breast reconstruction procedure include those who:
- Have an adequate amount of breast skin left after the mastectomy
- Underwent a skin-sparing or nipple-sparing mastectomy
Techniques
The implant-based breast reconstruction technique that is performed will depend on whether the patient is a good candidate for a staged or one-step procedure.
Tissue Expander
The tissue expander is used in staged breast reconstruction surgery. In this approach, the tissue expander is placed, during the mastectomy, in a pocket that is created beneath the pectoralis major muscle. The surgeon will then partially fill the expander with saline solution to stretch out the skin and tissue. Over the course of the next two months, the patient will return to the surgeon’s office to have more saline solution added to the tissue expander. Once the tissue expander has stretched the skin and tissues to a point that they can accommodate a breast implant, the patient will undergo a second surgery so the expander can be replaced with a breast implant.
Acellular dermal matrix can be used in staged and one-step breast reconstruction procedures. The acellular dermal matrix is a soft tissue graft material that helps regenerate bodily tissues that were damaged through injury. It also provides additional support and contour to the lower and outer areas of the tissue expander or breast implant, while the pectoralis muscles provides support to the front of the expander or implant. In a staged procedure, the AlloDerm acellular dermal matrix is placed with the tissue expander to provide additional support. In a one-step procedure, the dermal matrix is placed with the implant during the mastectomy.
Breast Implants
When a patient undergoes staged implant-based breast reconstruction, the implant is placed in the breast pocket months after the mastectomy. During the surgical procedure, the tissue expander is removed, and the breast implant is put in its place.
In a one-step procedure, the implant is placed behind the pectoralis major muscle, and the dermal matrix is used to provide soft tissue support and coverage to the areas that the pectoralis major muscle can’t reach. Both of these devices are placed at the time of the mastectomy.
Single vs. Double Breast Reconstruction
With any breast reconstruction procedure, Dr. Griffin will work to achieve good symmetry between the breasts. In cases of a double breast reconstruction, in which both breasts were lost to mastectomy, Dr. Griffin will rebuild both breasts using implant-based breast reconstruction techniques.
In cases in which only one breast was lost to mastectomy, Dr. Griffin will rebuild one of the breasts using implant-based breast reconstruction techniques. To achieve symmetry with the other breast, Dr. Griffin may recommend the use of a smaller breast implant, breast lift, or breast reduction. By treating the other breast, Dr. Griffin can improve symmetry by adjusting the size, shape, and location of the nipple and areola in both breasts.
Consultations
To find out if implant-based breast reconstruction techniques are right for you, contact Dr. John R. Griffin today.
