Types of breast reconstruction
There are two main types of breast reconstruction, Reconstruction using an implant or using your own tissue which is called “autologous reconstruction. In some occasions we may use a combination of the two.
1. Implant based reconstruction
Breast implants are used widely for both cosmetic and breast reconstruction purposes. They are Silicone gel filled implants and the safety of the implants we use has been verified and tested over many years and has the approval of MHRA and FDA.
The concept of implant based reconstruction is to create a pocket for an implant to be placed in after performing a mastectomy where some the skin (and sometimes the nipple is also preserved) of the breast is preserved. The implant is placed behind the chest wall muscle (Pectoralis major) which covers the upper pole of the implant. The lower pole of the implant is covered either by a portion of your own skin and fat with the top layer of the skin removed. This is called a dermal sling and is normally suitable for patients with large breasts where they have some redundant skin and the reconstructed breast has the appearance of breast uplift. In patients with moderate size breast the lower pole of the implant is covered by what is called “Acellular dermal matrix (ADM)” which is a biological mesh derived from animal skin or heart lining. It has been processed to make it completely safe to use in humans because it has been washed out from all its cells so it contains no cells but provides scaffolding for your body to build a layer of tissue on it.
The idea behind all this is that generally it is not possible to remove the breast and put an implant in under the skin. The implant will act as a foreign body, much like a splinter, and work its way out. The above mentioned techniques also provide an extra layer of tissue on top of the implant to give it more natural feel and appearance.