Francois J Duminy

PLASTIC & RECONSTRUCTIVE SURGEON

BREAST RECONSTRUCTION BY TISSUE EXPANDER AND PROSTHESIS

Once the Tissue Expansion growth has completed, the Tissue Expander is replaced with a permanent prosthesis. This Prosthesis is usually filled with a silicone cohesive gel that cannot leak or migrate even if the prosthesis was to be cut in half.

The operation, in our practice, is often done under Local Anaesthetic and sedation with minimal downtime

When the new breast has settled, it is sometimes necessary to make an adjustment to the other breast to obtain better symmetry.

Once the breasts are symmetrical in shape and size, a new Nipple and Areola are made to get the best possible symmetry and appearance.

 

Benefits experienced by most patients:

1. Limiting of the Physical impact of mastectomy

2. Limiting the Psychological impact of mastectomy

3. Restoring symmetry - making clothing easier to wear comfortably and confidently

4. Restoring Confidence

5. Fairly Quick procedure and simple recovery requiring one or two touch-ups to obtain reasonable symmetry.

 

Negative Aspects:

1. Scars (usually only the scar required for mastectomy)- with good Scar Care -usually fade within 9 to 18 months

2. Sensory Changes in the whole breast.

3. Surgical Complications - Infection (which may result in removal of the prosthesis), Bleeding, Haematoma, Seroma, Deep Vein Thrombosis.

4. In the case of a single mastectomy, it is difficult to obtain the same firmness in the normal breast as that found in the reconstructed breast.

5. As time goes by, the normal breast tends to sag more than the reconstructed breast producing increasing asymmetry.

6. This procedure is usually not suitable for patients who need Radiotherapy

7. The complications associated with breast prostheses are, in my opinion, slightly more prevalent in breast reconstruction. These include:

  • Capsular Contracture
  • Rippling
  • Ruckling
  • Palpaple prostheses
  • Trick movements in the breast when moving the arms

8. It is recommended by the FDA that breast prostheses should be replaced every 10 to 15 years.