Breast Reconstruction with Implants

Direct-to-implant breast reconstruction

At most medical centers, plastic surgeons perform breast implant surgery by placing the implant under your pectoral chest muscle, resulting in a flat, unnatural look. Implants placed under the chest muscle can be especially noticeable when you use your chest muscles, as this movement can create a visible distortion. Our board-certified plastic surgeons developed a new pre-pectoral breast reconstruction technique known as the P1 method to give you a better outcome. With the P1 method, we place the implant over your muscle. This approach produces little to no muscle deformity or pain since the muscle remains intact. Instead, the implant is placed directly under the skin, providing a more natural-looking reconstructed breast.

Planning and recovery

Many patients undergo implant breast reconstruction at MedStar Health immediately following their mastectomy, resulting in only one surgery with a shorter combined recovery time. Women who undergo reconstruction alone can typically return home the day after their procedure. In addition, the recovery process with the P1 method results in less pain and no chronic pain, unlike the traditional way.

When you are discharged, you may have one or more drains, which are small tubes that remove extra fluid from your surgery site while it heals. The fluid typically collects in a hollow ball that’s connected to the other end of your drain. Your reconstructive team will explain how to care for and maintain your drains and explain when you can safely remove them.

Breast reconstruction with tissue expanders

To help prepare for the insertion of a breast implant, you may undergo a breast reconstruction with tissue expanders. This technique involves stretching breast skin and muscle using tissue-expanding implants similar to balloons. By stretching the skin and muscle with a tissue expander, your surgeon can form a recreation of your natural breast shape.

Planning and recovery

During this type of reconstructive surgery, a MedStar Health plastic surgeon will insert a tissue expander beneath your chest muscle and fill the implant with saline. You may need to revisit us for one to two months to have the implant filled with more saline for further expansion. Once your breast(s) reaches the desired size, we'll conduct a second surgical procedure to replace the tissue expander with a permanent implant.

While breast reconstruction with tissue expanders requires more visits to our medical centers, it comes with the benefit of a shorter recovery period and more satisfying results. In addition, we find that many of our patients prefer this method of breast reconstruction because of the ease and flexibility of choosing their desired size.

Because reconstruction with tissue expanders doesn’t involve transplanting tissue from another spot on your body, this procedure has a shorter recovery period than other breast reconstruction options. You may not even have to stay overnight when receiving your permanent implant. However, you should still expect to be healing for several weeks after your procedure. You may also experience some discomfort during the expansion process.

While you heal, swelling will gradually decrease, and your breast shape will improve. Medication to control the pain and drainage tubes to remove excess fluids may be necessary for a short time. Any drainage tubes should be left in place until your doctor decides it is okay to remove them safely.