Reconstruction with implants

After breast removal, the breast can be reconstructed with implants. The aim is to create a breast shape that is as natural as possible. The procedure is a common method, in which silicone implants are very often used.

If enough skin remains after the removal of a tumour, the implant can be inserted either directly under the skin or under the breast muscle. If a lot of tissue and skin was removed due to a tumour, the existing skin must first be stretched and then an implant must be inserted underneath. To do this, the doctors use an expander, which is filled with more and more fluid over several weeks, thus preparing the existing tissue for the operation.

It is also possible to use an expander prosthesis, which is also increasingly filled with fluid and then remains there as a breast replacement. This makes a second operation unnecessary. With this method there are different procedures and different cutting techniques, which should be discussed with the patient in advance and a procedure agreed upon.

Advantages of this method are the simple technique and the lower effort. In contrast to the use of the patient’s own tissue, no further wounds and corresponding scars occur with this method. In addition, the patient is exposed to less pain and can expect faster wound healing.

A disadvantage and at the same time one of the most frequent complications is the danger of capsule fibrosis. Since the implant is a foreign body for the body, the body can also react to it. A thin layer of connective tissue may increasingly form around the implant.

This eventually hardens more and more and can eventually lead to severe pain. The breast then feels harder than usual and can also lose its shape as a result. If the capsular fibrosis is very pronounced, corrective surgery will most likely be necessary. This can be more difficult because more tissue has to be removed.

Reconstruction with own tissue

Another possibility to reconstruct the breast is to reconstruct the skin, fat and muscle tissue. There are also different techniques for this. In a pedicled flap transplant, the tissue to be transplanted is transplanted into the breast along with the blood vessels supplying it.

However, the doctor can also first remove the tissue completely, shape it into the breast and then connect the vessels in the breast under the microscope to ensure the blood supply. This procedure usually creates very natural breast shapes and for many patients a very satisfactory result is achieved. The quality of the skin depends on the place of removal and the surface of the skin itself. A distinction is made between different variants of reconstruction from the patient’s own tissue.