Implant Based Reconstruction
A breast reconstruction with tissue expanders is generally performed immediately after a mastectomy for breast malignancy or during the correction of congenital breast deformities. It involves placing a shaped breast tissue expander under the chest muscle or more recently on top of it. Tissue expanders are designed to be firmer and appear larger than a normal breast implant because they need to provide enough support to gradually stretch the overlying breast skin and muscle. Tissue expanders in general have a metallic port, which is accessed in the clinic with a magnet and filled through a small catheter. The lower border of the breast is frequently reconstructed with an extra layer of tissue called acellular dermal matrix, which acts to support and secure the tissue expander in place as it expands. If the expander is placed on top of the chest muscle or pre-pectoral, the breast pocket created beneath the mastectomy skin is recreated with the acellular dermal matrix covering the entire expander in the new pocket. The tissue expansion will start in the operating room and then be continued in the clinic by Dr. Farkas and his nursing staff when the initial healing phase is complete. Dr. Farkas usually recommends at least one night observation so that patients are comfortable and confident in their recovery after this type of surgery.