Breast Implant Reconstruction with Tissue Expander in Austin, TX

breast implant reconstruction patientA diagnosis of breast cancer changes life in an instant and is the beginning of a journey filled with medical tests and treatments to eliminate the disease. For many women, breast reconstruction is a critical step in the recovery process, both as a celebration of beating the disease, and to produce a feeling of wholeness and health again. If you are one of those women considering reconstruction either before your mastectomy or after your mastectomy is completed, breast reconstruction with implants might be a choice for you.

Many options exist for breast reconstruction after mastectomy, and nearly all patients are candidates for some form of breast reconstruction. The decision to reconstruct a breast due to the loss of the breast to cancer, the presence of the BRCA gene for breast cancer, or damage caused by radiation or infection is a highly personal one. Dr. Christine Fisher will listen to your goals and concerns so that she can work with you, your oncologist and your breast cancer surgeon to develop a safe treatment plan that fits your body type and your lifestyle.

Dr. Fisher is a skilled reconstructive breast plastic surgeon who is experienced at both traditional and advanced implant techniques. For some women, advanced breast reconstruction techniques can be used to achieve superior results using their own living tissue to restore the size and shape of the breast(s). No matter what type of breast reconstruction you choose, Dr. Fisher promises the highest level of patient care and the best possible aesthetic outcome for primary breast reconstruction for all the women that visit her at her Austin office.

Is Breast Reconstruction with Implants Right for You?

Many women choose an implant-based route for breast reconstruction. Factors to consider when weighing this option include:

  • You have sufficient healthy breast skin to create a pocket for the implant
  • Your slender frame does not provide adequate donor tissue for a flap (living tissue) procedure
  • You do not want the additional donor site incisions on the abdomen or thigh to remove donor tissue
  • You prefer to avoid flap reconstruction for other reasons
  • You are willing to have surgery on your healthy breast also to improve symmetry between the two breasts
  • You will not be undergoing radiation treatment that can significantly affect the short and long-term success of an implant procedure

Breast reconstruction using implants can be performed at the time of the mastectomy or at a point after the mastectomy is completed. The choice is yours but may be impacted by whether you will have additional cancer treatment after surgery or other variables specific to your situation. Dr. Fisher will discuss your desires and expectations to help you choose the best approach and will work closely with your surgical oncologist to ensure the best possible outcome.

Options in Breast Reconstruction with Implants

Dr. Fisher uses silicone implants for her patients seeking breast reconstruction due to their more natural look and feel. Long-term safety studies have established the safety of silicone breast implants. These silicone breast implants come in both teardrop (anatomical) and round shapes, which will produce a slightly different effect. Dr. Fisher will help you determine the right shape for you based on your body proportions and your desired result. In addition, you will be able to select between smooth and textured implant shells, as well as a range of sizes to give you a natural, balanced appearance.

Your Surgery Experience

There are a variety of steps that will be involved in your breast reconstruction using implants:

Your Consultation

Your initial meeting with Dr. Fisher is a long visit, which is spent discussing your lifestyle and reconstruction goals and answering your questions to determine the best course of action for your breast reconstruction. Dr. Fisher will take a full medical history including a complete summary of your breast cancer diagnosis and treatment path. She will discuss your expectations and the options for reconstruction surgery so that she can achieve your desired outcome. Dr. Fisher hopes that you will leave this appointment feeling comfortable with your choice to proceed with breast reconstruction and will understand the specific course you will take to rebuild and restore your breasts after cancer surgery.

The First Day of Your Breast Reconstruction Surgery

For many patients, the first step in breast reconstruction involves the placement of a breast tissue expander underneath the breast skin, which is often done at the same time as the mastectomy. This breast-shaped device features an easy-to-access port so that it can regularly be adjusted to create sufficient space for the implant. This inflatable device is wrapped in a regenerative support scaffold and placed under the mastectomy skin. Dr. Fisher prefers to place expanders on top of the pectoralis (chest) muscle to get a safe and more natural-looking result. She feels that this is a less invasive implant reconstruction option, which avoids a dynamic deformity of the breast with arm movement. Rarely, it may be placed under the pectoralis muscle if oncologically necessary.

Surgery to insert the expander takes about two hours, and Dr. Fisher will inject a long-lasting pain-blocking medication to reduce postoperative pain. You will spend one night in the hospital so that you can be monitored and cared for in the early hours following your surgery. Several drains are placed into the breast during this surgery and will remain for two weeks to prevent fluid buildup and infection in the surgical site.

Depending on the desired size of your new breasts, the tissue expander will be adjusted weekly at our office through the addition of saline through the port. The expander is gradually inflated like a balloon over a period of a few months until the skin and muscle can accommodate your desired implant size.

Second Step of the Implant Breast Reconstruction Surgery

During a second surgical procedure, which usually occurs about three months after the first procedure, the tissue expander is removed, and a breast implant is placed in the pocket that was created by the expander. The AlloDerm scaffold strengthens the pocket and creates a better aesthetic result.

Fat grafting may also be recommended to improve the thickness of the mastectomy skin and enhance the aesthetic contour of the reconstructed breasts, especially at the upper breast and cleavage. This two-step procedure involves removing fat cells from one area of the body like the abdomen or thighs via liposuction. The extracted fat is processed and then injected in small striped in three dimensions into the breast tissue to create a soft and smoothe contour in areas of the breast that may appear dimpled or recessed. Fat injections typically offer very long-lasting results.

Nipple Reconstruction

When this reconstruction can be performed with a nipple-sparing mastectomy, it produces an exceptionally natural-looking result. If a patient is a candidate for nipple-sparing mastectomy, the mastectomy surgeon removes the gland and duct through an incision hidden along the fold of the breast. For these patients, the nipple can be preserved, and an implant can be placed underneath the skin to replace the volume lost.

If the nipples must be removed as part of the cancer surgery, the patient can have nipple reconstruction if desired three months after the implant surgery. The new nipple is generally constructed of surrounding skin at a natural location on the breast. Three-dimensional areola tattooing is also available in the office to add color to the areola and the appearance of texture to the reconstructed nipple. Tattooing can be done in the office three months after the last surgery.

Recovery Overview

Dr. Fisher will provide you with clear post-operative instructions after your breast reconstruction to keep you comfortable and lower your risk for complications. Some swelling and bruising is common and will subside within a few weeks. You will have a prescription for pain medication to take for the first few days and a surgical bra will provide you with additional support and comfort and limit swelling. Dr. Fisher will see you regularly in her office to ensure your recovery is progressing well. Recovery from the surgeries involved with this type of breast reconstruction will vary depending on many different factors, such as whether you have the reconstruction at the same time as the mastectomy and whether you are having the expander placed. Most women are back to their day to day activities within about two weeks, with strenuous exercise restricted for at least one month, so the surgical sites have plenty of time to heal fully. Dr. Fisher will advise you throughout your recovery process on when it is safe to resume specific activities.

Results that Last

For the right patient, breast reconstruction using implants can be an effective way to restore your body and your self-confidence after your cancer diagnosis and treatment. Dr. Fisher is a board-certified plastic surgeon who specializes in breast reconstruction and offers a broad spectrum of techniques, so she can customize your surgery to create the aesthetic look you want. She will work closely with your oncology team as well to ensure your reconstruction does not compromise your treatment in any way. To find out more about an implant-based reconstruction, or any other breast reconstruction option, contact our office at 512-815-0123 to schedule a consultation with Dr. Fisher or send us a message online.

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