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Secondary Reconstruction with Simple Implant


Medical editor Truls Ryder MD
Plastic Surgeon
Oslo University Hospital
Norway

General

Breast reconstruction with an implant is the most applied surgery after a mastectomy.

Technically the surgery is a relatively simple procedure. The implant is placed in a sub-pectoral pocket. The method is most appropriate for women with small non-ptotic breasts.

Loss of a breast following a mastectomy creates a feeling of being less feminine in some women. Breast reconstruction can strengthen the self-image and is therefore a good option after mastectomy.

Indication

  • A patient's desire for reconstruction of the breast after mastectomy.

Contraindication

  • Previous irradiation can be a relative contraindication

Goal

  • To improve self-image 
  • Cosmetic appearance 
  • Anatomical balance

Equipment

  • Surgery fine tray
  • Retractors, retractor with light
  • Silicone implant(s) 

Preparation

  • The incision is outlined on the patient while in the upright position.
  • Determine the size of the implants based on width, height, and how much the remaining breast protrudes.
  • The surgery is performed under general anesthesia.
  • The patient lies in the supine position.

Implementation

Preoperative antibiotic prophylactic is administered.

  • The incision is made laterally in the mastectomy scar.
  • The submuscular pocket corresponding to the skin outline is prepared.
  • The pocket is filled with compresses to ensure hemostasis.
  • A vacuum drain is installed.
  • The surgeon changes gloves.
  • The implant is placed in the submuscular pocket.
  • The position of the implant is corrected according to the marks on the implant.
  • The incision is closed in three layers.
  • A compression bandage is applied.

Follow-up

The patient is discharged the same day unless there are complications requiring hospitalization, or if the patient lives far from the hospital.

The drain is removed as indicated by the surgeon which is usually when 20-30 ml have drained during 24 hours.

The breast bandage is removed after 4-5 days and the patient should use a sports bra 6-12 weeks.

Capsular contracture is the most common complication.


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