Reconstruction with implants offers advantages such as the shortness of the surgery , the technical simplicity and the fact that it does not produce new scars. However, it also has considerable limitations.
Although the surgery lasts a short time, completing the reconstruction process requires a much longer period, since one of the techniques most used, the expander, requires several months and several visits to the doctor to prepare a second surgical intervention where takes place the definitive reconstruction.
A second limitation of implants is that, unlike living tissue, implants are foreign to the human body and, at the same time, artificial elements that suffer a wear. That means that a replacement may be necessary in the future. The patient will need some time (a few months) to get used to the implant and to the sensations that it generates when you are doing certain movements. These are not painful sensations but some tightness or slight discomforts that make you aware that the reconstructed breast is not part of your body in the same way as the healthy breast.
Although many women may feel satisfied with the result achieved by the implants, these do not have the same shape, fall, movement and evolution as the natural breast: they are firmer and heavier and generally they usually remain that way. In fact, over the years, the implant ends up creating an asymmetry between both breasts that often requires additional plastic surgery. In other words, the implant is a static element, which does not change or evolve in harmony with the changes and evolutions of the rest of the female body.
Finally, complications such as capsular contracture or implant intolerance can happen in some women.
It should be noted, with some exception, that the scientific community agrees that breast reconstruction techniques with implants are not recommended in patients who have received radiotherapy.
Technique that can be applied in some women of little voluptuous breast and who have enough skin and an adequate thoracic structure to receive a direct implant during the reconstruction without having to resort to expansion methods or surgery to replace that implant by another.
Technique that requires the use of expanders in the first instance. The expansion consists of dilating the skin and the subcutaneous cellular tissue (of the chest area) through a refillable implant that fills progressively in outpatient visits (without entering in the hospital) until the necessary space is available to accommodate a definitive prosthesis.
The first step of this intervention is to create a space under the pectoralis major muscle to place the expander, which acts as a kind of temporary implant. This implant incorporates a valve that, through a small, painless puncture, allows the saline serum to be filled through the skin that fills the prosthesis.
Later, the expander is progressively inflating with saline serum for several weeks (between 4 and 6 months) to create a space or bag under the musculature of sufficient size to accommodate the implant in the most natural way, and thus reproduce the shape of the other breast.
Once the expansion process has been successfully completed, it is necessary a few weeks to settle the implant and the skin, after that we can replace the prosthesis with a definitive one. Thereafter a second operation is performed to replace the expander with a fixed volume final implant.
Technique that is only used in a limited number of patients and in environments where the economic resources for the mammary reconstructions are very limited. They are implants that allow a certain degree of expansion of the tissues of the thorax but when they have achieved the necessary volume to restore the form of the breast, they are not changed or replaced, and remain as definitive shape. The downside of this implant is the poor aesthetic results, especially the shape of the breast, as well as wear, and the risk of losing volume because of the infiltrated saline lost.
Breast reconstruction techniques:
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