Implant-Based Breast Reconstruction

This approach may be well-suited for you if you have sufficient healthy skin after mastectomy, desire a shorter initial surgery and recovery, have limited donor tissue for a flap, or prefer to avoid additional scars on other parts of your body. Mr Ibrahim will assess your specific anatomy and cancer treatment plan to advise if it is your safest and most appropriate option.

Most commonly, silicone gel implants are used for their natural feel and appearance. Mr Ibrahim will discuss the options regarding shape (round or anatomical) and surface texture, helping you choose based on your body frame and desired outcome.

Hospital Stay

Typically 1-2 nights.

Initial Recovery

You will have surgical drains and wear a supportive bra. Discomfort is managed with medication. If you have an expander, the filling process in clinic is usually well-tolerated.

Returning to Activities

Most patients return to light, desk-based work within 2-3 weeks. Strenuous activity and heavy lifting must be avoided for at least 6 weeks.

After Stage 2

The exchange surgery has a shorter recovery, often with a return to normal activities within 2 weeks.

All surgery carries risks of bleeding, infection, and anaesthesia complications. Specific risks include:

Capsular Contracture

The formation of tight scar tissue around the implant, which can cause firmness, discomfort, or visible distortion. This is the most common reason for revisional surgery.

Implant Rupture or Leakage

Modern implants are very durable, but they are not lifetime devices. Routine monitoring is advised.

Implant Malposition or Rippling

Where the implant shifts or its edges become visible.

Need for Future Surgery

Implants may need to be replaced or revised in the future.

Radiotherapy can increase the risk of complications like capsular contracture and poor wound healing with implants. In many cases, a two-stage approach is used, where the temporary expander is placed to preserve the skin space. The permanent implant is placed several months after radiotherapy is complete, once the tissues have recovered. Mr Ibrahim will carefully plan the timing.

Breast implants are durable medical devices, and can be lifetime devices if the changes are tolerated and accepted by the patients. While many implants last for 10-15 years or longer without issue, the likelihood of requiring replacement or revision surgery increases over time. Reasons for future surgery can include capsular contracture, implant rupture, rippling, malposition, or a personal desire to change size. You should plan for long-term monitoring of your implants.

It is important to have realistic expectations about sensation. A mastectomy necessarily disrupts nerves, leading to a permanent loss of normal nipple sensation and a significant reduction in skin sensation on the breast. Sensation may partially and gradually return in some areas over time, but it is highly variable. The goal of reconstruction is primarily to restore breast form and contour.

Acellular Dermal Matrices (ADMs) are specially processed biological or synthetic tissues used as an internal support scaffold in some implant reconstructions. They can help provide better definition to the lower breast fold (inframammary crease) and improve implant positioning. Mr Ibrahim will discuss whether using an ADM is appropriate for your specific surgical plan, as their use depends on your anatomy and the type of reconstruction.