I am interested in breast implant reconstruction after my breast cancer surgery. What is involved?

Last Modified: May 8, 2009

Dear OncoLink "Ask The Experts,"

I am interested in breast implant reconstruction after my breast cancer surgery. What is involved?

Rachel McKenna, MSN, CRNP, Nurse Practitioner in the Division of Plastic Surgery at the University of Pennsylvania Hospital, responds:

Implant reconstruction is almost always at least a two-step procedure. At the time of mastectomy, we will put in a tissue expander, which is a balloon device that is placed underneath the skin and muscles of the chest wall. At the time of surgery, the surgeon will put in a small amount of saline (salt water) into the expander through a valve in the device; however, you will be essentially flat. You are usually in the hospital for 2 days for this surgery, and recovery time is about 4 weeks.

After you heal from the mastectomy, approximately 3-4 weeks, you will begin the process of tissue expansion. This means that you will need to come into the office on a weekly or every other week basis. At your office visit, a small needle will be inserted through the skin in the chest wall and into the valve in the tissue expander. A small amount of saline is added at each visit. The chest muscle and skin are slowly stretched to accommodate the appropriate sized implant. Once your tissue expanders have the correct amount of saline in them you will need to wait another 4-6 weeks before the second stage of the surgery. If you need to undergo chemotherapy, the next stage is delayed until chemotherapy is completed.

In the second stage we will go in through the same incision on the breast, remove the tissue expander and place implants. This can be either silicone (gel) or saline filled implants. Both types of implants are made of a silicone shell, the difference is what the implants are filled with. Both are safe. Your surgeon will help you to make the choice of permanent implants that are best for you. This surgery does not require an overnight stay in the hospital and recovery takes about 2 week.

The whole process from time of mastectomy to when the final implants are placed takes anywhere between 3-6 months.