After mastectomy, the surgeon inserts a balloon-like expander beneath the chest muscle. Periodically, over several weeks or months, through a tiny valve-like mechanism buried beneath the skin, a saline solution is injected to slowly fill the expander. When the skin over the expander has stretched enough, in a second operation the expander will be replaced with a new implant.
It should be pointed out that some expanders are designed to be left in place permanently. The nipple and the dark area of skin surrounding the nipple may be reconstructed later. Some women do not require placement of an expander to stretch their skin, so the surgeon can immediately put in the implant.
An alternative breast reconstruction technique that is performed by making a skin flap using tissue taken from other parts of the body (the back, abdomen).
There are two methods to perform this procedure. The first one is to use the tissue that is still connected to the region from which it is taken, or maintains an uninterrupted blood supply. The flap consisting of the skin, fat, muscle with its blood supply, is tunneled beneath the skin to the chest, creating a pocket for the breast implant, or sometimes, this tissue portion alone is enough to reconstruct a breast, and an implant insertion may not be required.
The other procedure uses the tissue taken from the abdomen, thighs or buttocks which is then tunneled into the chest wall cavity. This procedure requires restoration of blood supply to the flap.
Breast reconstruction using a woman’s own tissue results in a more natural appearance, and excludes potential negative effects of silicon implants. It should also be pointed out that this procedure changes the appearance of the abdomen, it appears tightened. Disadvantages of the procedure include a longer recovery, higher complication rate and larger scar both on the breast and at the site where the flap was taken.
