Tissue Expander and Implant-Based Reconstruction

Dr. Fusi F.A.C.S. M.B.A. has twenty years of breast reconstruction experience and currently serves as a clinical faculty member of Plastic and Reconstructive Surgery at the Yale School of Medicine. Dr. Craig is a board-certified plastic surgeon who has obtained years of plastic surgery and reconstructive training at MD Anderson Cancer Center in Houston and Yale, integrating the newest reconstructive techniques with her multi-disciplinary approach to breast cancer patients.

Dr. Fusi and Dr. Craig’s practice integrates the latest advancements in implant-based reconstruction for improved aesthetic results.

What Is Tissue Expander And Implant-Based Reconstruction?

A tissue expander and implant-based reconstruction is a common technique that involves your reconstructive breast surgeon inserting temporary, inflatable breast implants (called breast tissue expanders) that are designed to gradually stretch the skin to make enough room for the final implant. The tissue expander, which is placed under your skin and chest muscle, is equipt with a tiny port. Following surgery, you will receive a series of saline solution injections into the tissue expanders, gradually filling them over time. After these injections, you may experience a stretching sensation and some pain or pressure that should not last more than a few hours. When your skin has finally stretched enough, the tissue expander is removed and exchanged for a permanent implant which restores the volume, shape, and profile of your natural breasts. If your surgical oncologist has recommended chemotherapy or radiation after your mastectomy, the tissue expanders will be implanted at a time that does not interfere with your cancer treatments. While many women that live in the Houston area do decide to undergo tissue expander and implant-based reconstruction, the procedure is not recommended for all patients because of the increased risks associated with factors such as:

  • Radiation treatment.
  • Autoimmune diseases.
  • Previous surgical treatment.

Dr. Fusi and Dr. Craig will elaborate on the benefits and possible risks associated with tissue expander implant-based breast reconstruction during your initial consultation.

Should I Choose Tissue Expander And Implant-Based Reconstruction?

Tissue expander and implant-based reconstruction typically present women with very low risks when they are thoroughly and carefully screened. During a consultation, Dr. Fusi and Dr. Craig will help you evaluate different techniques that will help you to achieve the results that make you feel the most comfortable and confident with your body. Both Dr. Fusi and Dr. Craig will thoughtfully guide you through the treatment process by:

  • Developing a comprehensive plan for tissue expander and implant-based reconstruction that works best with the type of mastectomy performed by your breast surgeon.
  • Advising you on whether immediate implants or a two-stage reconstruction will be more effective.
  • Timing surgical procedures with your cancer treatment.

Before deciding on a type of breast reconstruction procedure, you should consult your breast surgeon and a plastic surgeon about the options that are best for you.

Click here to read Dr. Craig’s published article on Tissue Expanders in Breast Reconstruction.

Direct To Implants Vs. Two-Staged Reconstruction

Implant-based breast reconstruction can involve your breast plastic and reconstructive surgeon inserting the tissue expander at the same time that your breast surgical oncologist is performing your mastectomy and is referred to as “direct to implant.” The second type of procedure is called the two-staged breast reconstruction method and may involve two or more stages. Dr. Fusi and Dr. Craig will base their recommendations concerning which procedure is best for you on the type of mastectomy your breast surgical oncologist performs, and they will also evaluate your breast anatomy during surgery.

  • Direct to implant (immediate implant): An immediate implant is best for women who want to keep the same breast size or reduce the size of their breasts, and do not need radiation therapy. Although an immediate implant may limit the number of procedures, many Houston patients will require breast revision surgery to arrive at their ideal results.
  • Two-stage: During your initial surgery the tissue expander is inserted into the breast pocket to maintain or expand the size of the breast pocket at the time of your mastectomy. This prepares the area for an implant by gradually filling a tissue expander until the desired size is reached. The second procedure will place the permanent breast implant, and additional revisions may be required to achieve the most pleasing aesthetic result.

Dr. Fusi and Dr. Craig will provide you with insightful information regarding the timing for your implant-based breast reconstruction. Based on the size of your breasts and your desired results you will work in conjunction with the doctors to choose the best option.

Possible Complications

Patients living in the Houston area who fall into the obese weight range have much higher rates of complications than patients who are of average weight. For their obese patients, Dr. Fusi and Dr. Craig recommend either oncoplastic reduction or free flap surgery to reduce the risks associated with implant-based reconstruction. Patients who have been adequately screened for implant-based reconstruction have a relatively low rate of complications such as:

  • Delayed healing.
  • Implant rupture or leakage over time.

The incidence of complication is further reduced by choosing a plastic surgeon who has the experience and qualifications required to perform this surgery successfully.

Recovering At Home

After your implant reconstruction surgery, Dr. Fusi and Dr. Craig will provide you with precise instructions that need to be followed diligently. Because all patients are unique, each will receive specific guidance and instructions that may vary slightly. Your at-home recovery regimen may include certain exercises to prevent stiffness and problems with scar tissue build up. Detailed instructions on how to properly care for staples, stitches, dressings, and surgical drains will also be provided, and it is critical that Houston breast reconstruction patients stay vigilant about their at-home recovery process and you should report anything that appears unusual to your doctors immediately.

Psychological Benefits Of Implant-Based Breast Reconstruction

The initial shock of being diagnosed with breast cancer is, in itself, a profoundly frightening and life-changing experience for a woman. The emotional turmoil is then further compounded when you are told that a mastectomy is in your future. But when patients are presented with the option of being able to restore their breasts with implant-based breast reconstruction, these women often experience a huge sense of relief knowing that what most women associate with their femininity will not be permanently lost. It is significantly beneficial to a breast cancer patient’s state of mind because when patients have a positive mental attitude, it often affects how well they heal and can dramatically improve their quality of life.

Although your treatment plan may call for a two-stage tissue expander-implant breast reconstruction or revision surgery following a direct implant procedure to achieve your desired results, requiring you to wait some time, they can look forward to an outcome that allows them to feel whole again.

Dr. Fusi and Dr. Craig have the honor of witnessing patients who initially walk into their Houston office during, perhaps, the most difficult and trying time in their lives, transform into vibrant, confident women who go on to fully enjoy their lives again. As plastic surgeons, being able to help these women is a tremendously rewarding and satisfying experience. Establishing open, transparent, and genuinely meaningful connections with their patients ensure that your goals, needs, and feelings are fully understood and help patients better achieve positive outcomes.

What Qualifications Should My Plastic Surgeon Have?

The plastic surgeon that performs your implant-based breast reconstruction will work closely with your breast cancer surgeon and consult with them throughout surgery. These medical professionals will form a surgical team that works together to completely remove the breast cancer and restores the appearance of your breasts. To get the best possible care, check that your plastic surgeon has:

  • Specialization in breast reconstruction.
  • Excellent training.
  • Knowledge of cancer treatment and its effects on different options for breast reconstruction.

Dr. Fusi has spent twenty years acquainting himself with the latest developments in breast reconstruction. Both Dr. Fusi and Dr. Craig are Yale-trained specialists. Dr. Craig obtained years of breast reconstructive experience at MD Anderson Cancer Center, the nation’s leading cancer center. Their combined experience, knowledge, and exceptional patient care provide their Houston patients with superior treatment options for breast reconstruction.

To discuss implant-based reconstruction call our Houston office at (713) 346-9909. Our knowledgeable and well-trained staff are here to help you set-up a convenient time to come in for an initial consultation.