Implant-Based Reconstruction

The goal of breast reconstruction is to restore one or both breasts to near normal shape, appearance, symmetry and size following mastectomy. Dr. Lindsey Webb is a board-certified plastic surgeon in Atlanta who specializes in breast reconstruction and can offer a wealth of experience with patients, expertise in microsurgery and implant placement, an empathetic bedside manner, and a woman’s perspective.

Breast reconstruction generally falls into two categories: implant-based reconstruction or autologous flap reconstruction (using one’s own body tissue). Implant reconstruction relies on breast implants to help form a new breast mound. Flap (or autologous) reconstruction uses the patient’s own tissue from another part of the body to form a new breast.

Breast reconstruction may not re-create the exact look and feel of your natural breast but the goal is for you to feel comfortable in your own skin and to restore the sense of femininity, sexuality, of feeling whole.

Implant reconstruction often involves multiple procedures performed in stages. It begins with placement of a breast implant or tissue expander, either at the time of your mastectomy (immediate reconstruction) or during a later procedure (delayed reconstruction). Breast reconstruction often requires multiple operations, even if you choose immediate reconstruction.

One type of breast reconstruction uses breast implants — silicone devices filled with silicone gel or saline fluid — to reshape your breasts.

A breast implant is a round or teardrop-shaped silicone shell filled with saline or silicone gel. It is only natural to have concerns about breast implant safety and Dr. Webb will walk you through the process and the risks to help you make informed decisions about your procedure. Numerous studies over the past decade have supported the safety of breast implants – both saline and silicone gel. All implant shells are made with silicone which is an inert substance used everywhere from joint replacements to scar gels to skin care products. Saline and silicone implants have similar risks of rupture, infection, and capsular contracture which is the excessive scar tissue formed around an implant. They do ‘feel’ differently and, depending on how much skin and native breast tissue a patient has, they may look differently. There is an association with textured implants and a very rare form of lymphoma known as ALCL and, until more published scientific data is available, we will likely recommend a smooth implant for you.

Dr. Webb places the implant either behind or in front of the pectoralis muscle in your chest. The implants may be covered or secured in place using a special tissue called acellular dermal matrix. Over time, your body incorporates and replaces this tissue with natural collagen.

Some women are able to have the permanent breast implant placed at the time of the mastectomy (direct-to-implant reconstruction). However, many women require a two- stage process, using a tissue expander before the permanent implant is placed.

Tissue expansion is a process that stretches your remaining chest skin and soft tissues to make room for the breast implant. Dr. Webb places a tissue expander under or over your pectoral muscle at the time of your mastectomy. Over the next few weeks, through a small valve under your skin, Dr. Webb uses a needle to inject saline into the valve, filling the expander in stages. This gradual process allows the skin to stretch over time. The expansion itself is generally well-tolerated; at most, you may experience some discomfort or pressure as the implant expands. Once the expander is at your desired size, Dr. Webb performs a second quick outpatient surgery to remove the tissue expander and replace it with a permanent implant.

Breast reconstruction may also entail reconstruction of your nipple. Typically, a small incision is made at the site where the nipple will be made. The skin is formed into a nipple shape and small sutures are used to secure the form. The new nipple and surrounding areola can be tattooed about 3 months after surgery.

Webb Plastic Surgery is one of the few locations in the Southeast that offers our breast reconstruction patients the option of 3D tattooing. 3D Nipple Tattooing is a method that may be used to create an image of a nipple on the skin with dimensional shading within the pigment of the tattoo ink. This technique adds visual realism to the coloration used to restore the nipple pigment. 3D Nipple Tattooing is completed under sterile conditions in the comfort of our office.