Informative material about breast reconstruction procedures after breast cancer.

Breast reconstruction can be performed a long time after mastectomy (delayed reconstruction) or immediately, at the same time as mastectomy surgery (immediate reconstruction).

Many breast implants are available on the market of different kinds, brands, shapes and proportions; they all share an outer silicone rubber shell and an internal chamber which can contain silicone gel, hydrogel, or saline solution as for the expandable implants (tissue expanders). Breast implants do not vary just in their content, indeed there exist a large variety with different shapes and proportions. The simplest implants are the round ones, with a circular base and which develop with different projections for more or less voluminous breasts. Another group of implants is formed by the anatomical ones, their profiles resemble drop shapes and therefore have their maximum projection not in the middle of implant, but shifted closer to the inferior pole, such implants have a shape which is more similar to that of a common moderately ptotic breast. Expandable implants too are available in both shapes. Beyond content and shape, another distinctive feature for a breast implant is the surface. Indeed, through different production processes or chemical-physical treatments applied on the surface, implants can become smooth or textured. While smooth implants give an unequivocal visual and tactile feeling, textured implants present more variability among them and are mainly divided in microtextured, macrotextured and macrotextured with a polyurethane foam coating. Immediate reconstruction can thus be performed in one or two stages:

• TWO-STAGE RECONSTRUCTION: This method requires two surgeries. During the first one, the surgeon places a tissue expander underneath the pectoralis major muscle. Then, this tissue expander will then be inflated in an outpatient setting to recreate the shape of the breast. During the second surgery, the surgeon replaces the now completely inflated expander with the final implant of about the same size.

• ONE-STAGE RECONSTRUCTION: This procedure is completed in one surgery, during which the surgeon places the final implant underneath the pectoralis major muscle.