Stage 1: The first stage involves placement of tissue expanders. This can either be done at the time of the mastectomy (for immediate reconstruction patients) or after the mastectomy has healed (for delayed reconstruction patients). Expanders are essentially temporary implants that act as spacers. Breast reconstruction with implants or tissue expanders, in our practice, is generally reserved for patients who do not have adequate tissue for a flap reconstruction, or do not wish to use their own tissue for reconstruction.
Stage 2: The expanders are filled as much as possible at the time of the initial surgery. Further expansion is performed in the office as required once the incisions have healed. This expansion process can require several weeks, depending on the amount of expansion required by the patient to reach the optimal breast size.
Stage 3: Once the tissue expanders are adequately filled they are exchanged for permanent breast implants. Two types of breast implants are available to patients: Saline and Silicone. It is advised that you speak with your plastic surgeon as to which implant would be best for you. Patients who undergo breast reconstruction with implants should be aware that their implants may need to be replaced at a future date.
June 4th, 2008 is my surgery date for this final step. I chose silicone implants because of my diagnoses of ductal carcinoma. With the silicone implants you get the benefit of a yearly MRI. This will also show if the cancer has come back anywhere. With the saline ones the Insurance won't pay for the yearly MRI, they will pay with the silicone ones. Dr. Melissa Goddess told me the silicone ones look much more natural and feel softer to. So I got that going for me. I am so excited I can't wait to be done with all of this and to get back to my life.
Here is a photo of a woman who has had reconstruction surgery after bilateral mastectomies. She chose silicone. I think they look pretty damn good. I wish I could show you my sister Lee's but I promised her I wouldn't.