Many women considering breast reconstruction elect to use implants to help re-form their breasts. By using tissue expanders to create a pocket for a permanent implant, our surgeons can help women regain their feminine form. Implant-based breast reconstruction is advantageous in that the same incisions used during your mastectomy procedure can be used to perform your reconstruction. You may even be a candidate for direct-to-implant (single-stage) breast reconstruction, in which an implant is placed immediately after the mastectomy, limiting the number of total surgeries throughout your breast reconstruction journey. 

View some photos of implant-based breast reconstruction in our Before & After Gallery. If you believe implants are an ideal strategy for your breast reconstruction, please call 720-457-4461 to discuss your options during a private consultation.

Stage One

During the first stage of your implant-based breast reconstruction, a tissue expander will be placed beneath your pectoralis major muscle. Our Colorado breast reconstruction surgeons use AlloDerm® to cover the lower portion of the tissue expander without stretching your pectoralis muscle. This allows you to achieve more rapid expansion, shortening the first stage of tissue expansion down from several months to several weeks.

Once your tissue expander has reached a satisfactory volume level, the second stage of your reconstruction can be scheduled.

Stage Two

Stage two of implant-based breast reconstruction is the main surgical procedure itself. During this procedure – which usually lasts 1-2 hours – your tissue expanders will be removed, along with any scar tissue that has developed in your breast pockets. The implants will be placed into the pockets, and one small drainage tube may also be placed into each breast. This drainage tube will be removed the following week.

You can choose to use either saline breast implants or silicone breast implants. Your surgeon will help you understand the pros and cons of each choice as they relate to your specific needs.

Stage Three

Once your implants have been placed, we will give them several months to settle before we move into the final stage: nipple reconstruction. This step can be performed by itself, or in combination with enhancement procedures such as scar revision or fat grafting. If implant edges are showing, or there are defects in your contours, fat grafting can be used to smooth these imperfections out and provide you with the best final appearance possible. Fat grafting includes liposuction of an area of your body, and then filling in those breast contours with that harvested fat.

In an ideal situation, where there is no need for post-operative radiation therapy or chemotherapy, total breast reconstruction using implants can be completed in less than 12 months – sometimes much less.

You can rest assured that during every step of the process, our experienced staff here at The Breast Center Park Meadows Cosmetic Surgery will be ready to meet your needs and address any concerns you have.

Post-Operative Instructions for the Placement of Tissue Expanders

Diet:

Start with clear liquids and toast or crackers. If those are well tolerated, progress to a regular diet.

Wound Care:

You will have a 1 or 2 drains in each breast. A drain kit with instructions and teaching by the nursing staff will be provided at the hospital. Empty and record (in “cc” amounts) the drainage amount once or twice per day after discharge from the hospital and bring your drain record with you to each clinic appointment. 

All of your sutures will be under the skin. You will either have a layer of skin glue that resembles clear nail polish or steri-strips, similar to tape, on all of your incisions. Please do not remove the steri-strips. Your surgeon will remove the dressings, if needed. 

You may feel and see the expander under the skin most pronounced at the midline.

Pain & Swelling:

While in the hospital, your pain will be monitored very carefully. Pain medication will be prescribed to you to use as needed postoperatively. Pain is best controlled with lower doses of multiple medications such as Tylenol, Celebrex and narcotics.

You can expect moderate swelling in the reconstructed breast, underarm and abdomen.  You will have numbness in the reconstructed breast and abdomen for up to 12 months. 

Garments:

Do not wear a compressive bra for the first 3 weeks. You may wear a light camisole for gentle support.

Bathing:

You may shower and wash your hair 48 hours after surgery. You may get your incisions wet, but do not direct the water spray at your incision site. Pat dressings dry. Do not submerge the incision in a bath or swimming pool or hot tub for the first 4 to 6 weeks. Support your drains in the shower around your neck or waist. 

Medications:

Take pain medication as needed for up to 4 weeks in moderation and at night if needed. While you are taking pain medicine, you are encouraged to follow a high fiber diet or take a stool softener such as Colace (available over the counter), as pain medications tend to cause constipation. Do not take Motrin/Ibuprofen or Aspirin products for 1 week after surgery. Ask your surgeon when you may resume your blood thinning medications. All other prescription medications may be resumed immediately, as discussed with your physician. Take your full course of antibiotics if prescribed by your surgeon.

Sleeping:  

During the first 2 weeks, place pillows under your head and knees. Sleeping in a recliner may be most comfortable to keep the upper body supported. After the first 2 weeks, sleeping on your side and back is permitted, but not on your stomach. After 4 weeks, resume normal and comfortable sleeping positions. 

Activity:

You may walk and climb stairs immediately following surgery. After 2 weeks you may resume moderate activity such as brisk walking. No sexual activity for 3 weeks. During the first 4 weeks, do not lift anything heavier than a gallon of milk (10 pounds). No heavy exercise for 4 weeks (tennis, yoga, pilates, jogging, aerobics, weights, etc.). After 6 weeks you may resume more strenuous aerobic work and lifting activities. No abdominal exercises for 8 (+) weeks. 

Driving:

No driving for 2 or 3 weeks after your procedure or while taking pain medicine.

Alcohol, Smoking, and Cannabis:

Do not smoke for the first several weeks after surgery as it impedes wound healing and can lead to serious wound complications. Smoking and alcohol consumption are dangerous while taking pain medicine. It has a tendency to worsen bleeding. If you use marijuana (cannabis), please discuss with your physician.

Post-Operative Appointment:

Your first follow-up visit will be approximately 1 week after surgery. Your surgeon will then see you at appropriate intervals after this to monitor your progress.

Physical Therapy:

A prescription for physical therapy will be given to you at either your pre-operative appointment or  your first post-operative appointment. Gentle range of motion exercises are encouraged during the first 2 weeks.

Work & Travel:

Depending on your career and your rate of healing, you should be able to return to work within 4 to 6 weeks of surgery. If your job involves heavy lifting, please allow 8 to 12 weeks before returning to work. Your surgeon will be able to give you a better estimate depending on your physical and professional profile. Flying or traveling is permitted after the first week as tolerated. 

Special Considerations:

Call your surgeon immediately if you experience any of the following: excessive pain, rapidly expanding swelling under the skin, bleeding, redness at the incision site or pus drainage from incision, spreading bright pink discoloration, or fever over 101.5° F.

Call 911 if you are experiencing a life-threatening emergency. Such symptoms include severe shortage of breath, chest palpitations, sudden or sever chest pain, or other life-threatening concerns.

If you would like to learn more about implant-based reconstruction, please contact The Breast Center Park Meadows Cosmetic Surgery online or call 720-457-4461 today to schedule your initial consultation with our Colorado breast reconstruction team.