This procedure usually requires multiple steps. First, a balloon-like pouch called a tissue expander is placed under the skin and chest muscle. Every week or so, two to four ounces of salt water are added through a valve. This stretches skin and tissue over about two months to make room for the implant and create a natural-appearing breast shape. After two to four months of recuperation from that surgery -- and, if needed, chemotherapy and radiation -- the expander is removed. A salt-water or silicone-filled implant is placed through the mastectomy scar and under the chest muscle to provide shape and volume.
In general, for two to four weeks, you can't drive, exercise, participate in sports, or lift more than five pounds. Women can return to work two to three weeks after a mastectomy and expander, or after the implant is inserted.
Seventy percent of women have no complications. About 2 percent experience infection or bleeding, and because an implant is foreign to your body, an infection of the chest wall may require implant removal. Up to 10 percent of implants leak within the first year. Excess scar tissue can squeeze the implants and cause pain and contour distortions. Leakage and distortions can occur years later.
The recovery time is about half that of the more complicated flap operations, but "there are two surgeries, thus two recovery times," Wilkins says. An implant also is less likely to match a natural breast in shape and texture. Women may desire an implant in their other breast to create symmetry.
Continued on page 2: Natural Tissue Flap
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