How does breast reconstruction work

Talk to your doctor about what you can expect. Be sure you understand how to take care of your surgery sites and how to follow up with your breast care, including regular mammograms and when they are needed depending on the surgery you have had.

Any type of surgery has risks, and breast reconstruction may pose certain unique problems for some women. Even though many of these are not common, some of the possible risks and side effects during or soon after surgery include:. Infection can happen with any surgery, most often in the first couple of weeks after the operation. If you have an implant, it might have to be removed until the infection clears. A new implant can be put in later. If you have a tissue flap, surgery may be needed to clean the wound.

The most common problem with breast implants is capsular contracture. A scar or capsule can form around the soft implant. As it tightens, it can start to squeeze the implant, making the breast feel hard. Capsular contracture can be treated. Before your surgery, follow your doctor's specific instructions on preparing for the procedure. This may include guidelines on eating and drinking, adjusting current medications, and quitting smoking.

During tissue expansion, a balloon inserted under your chest muscle is gradually filled with saline over a period of several weeks or months. The gradual inflation of the balloon stretches the skin and tissue over your chest to make room for an implant. Breast reconstruction begins with placement of a breast implant or tissue expander, either at the time of your mastectomy immediate reconstruction or during a later procedure delayed reconstruction. Breast reconstruction often requires multiple operations, even if you choose immediate reconstruction.

A breast implant is a round or teardrop-shaped silicone shell filled with salt water saline or silicone gel. Once restricted because of safety concerns, silicone gel implants are now considered safe. A plastic surgeon places the implant either behind or in front of the muscle in your chest pectoral muscle. Implants that are put in front of the muscle are held in place using a special tissue called acellular dermal matrix.

Over time, your body replaces this tissue with collagen. Some women are able to have the permanent breast implant placed at the time of the mastectomy direct-to-implant reconstruction. However, many women require a two-stage process, using a tissue expander before the permanent implant is placed. In pre-pectoral breast implant placement, the implant is placed on top of the chest pectoralis muscle.

After mastectomy, a balloonlike tissue expander can be placed between your chest muscle and your skin. The tissue expander is gradually filled with saline to stretch the breast skin and make room for a breast implant. To support your breast skin, the surgeon may insert a layer of collagen cells tissue matrix around the expander.

Over time, your own cells fill in the matrix to create supportive tissue to hold the implant in place. You will need a second surgery to exchange the tissue expander for a permanent implant. Tissue expansion is a process that stretches your remaining chest skin and soft tissues to make room for the breast implant.

Your surgeon places a balloonlike tissue expander under or over your pectoral muscle at the time of your mastectomy. Over the next few months, through a small valve under your skin, your doctor or nurse uses a needle to inject saline into the valve, filling the balloon in stages. This gradual process allows the skin to stretch over time. You'll go to your doctor every week or two to have the saline injected. You may experience some discomfort or pressure as the implant expands.

A newer type of tissue expander uses carbon dioxide. This remote-controlled expander releases the gas from an internal reservoir. Compared with the expansion using saline, the gradual expansion using carbon dioxide may decrease the amount of discomfort you feel. After the tissue is adequately expanded, your surgeon performs a second surgery to remove the tissue expander and replace it with a permanent implant, which is placed in the same place as the tissue expander. You may be tired and sore for several weeks after surgery.

Your doctor will prescribe medication to help control your pain. Your doctor will let you know of restrictions to your activities, such as avoiding overhead lifting or strenuous physical activities.

Don't be surprised if it seems to take a long time to bounce back from surgery — it may take as long as a year or two to feel completely healed. Cancer Health Disparities. Childhood Cancers Research. Global Cancer Research. Cancer Research Infrastructure. Clinical Trials. Frederick National Laboratory for Cancer Research.

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Breast Cancer Screening. Breast Cancer Treatment During Pregnancy. Breast Reconstruction After Mastectomy. On This Page What is breast reconstruction? How do surgeons use implants to reconstruct a woman's breast? How do surgeons use tissue from a woman's own body to reconstruct the breast?

How do surgeons reconstruct the nipple and areola? What factors can affect the timing of breast reconstruction? What factors can affect the choice of breast reconstruction method?

Will health insurance pay for breast reconstruction? What type of follow-up care and rehabilitation is needed after breast reconstruction? Does breast reconstruction affect the ability to check for breast cancer recurrence?