ID Sein

Reconstruction with prosthetic implant

The quality of a breast reconstruction using a prosthetic implant depends on :

  • the thickness and suppleness of the tissues ;
  • the way in which the surgeon fixes the inframammary fold (the crease under the breast) ;
  • the choice of prosthesis.
Reconstruction with prosthetic

Innovation: "Filling" before breast reconstruction

After a mastectomy, when the tissues covering the chest wall are too thin, complications (such as infection, exposure of the prosthesis) are more frequent and the result is often poor. To overcome this drawback, we have developed a technique for fat transfer, called 'filling', which is carried out before reconstruction to increase the thickness of the tissues that will cover the prosthesis. By significantly improving the quality of the results and reducing the risk of complications, this technique enables reconstructions using prostheses to be offered to a larger number of patients and therefore reduce the need for using flaps.

The fat is removed using liposuction (abdomen, hips and or thighs), then injected under the chest skin before the prosthesis is implanted. It is often necessary to carry out two fillings like this to achieve a satisfactory result.

Filling before reconstruction with prosthesis
Filling before reconstruction with prosthesis

BRAVA is a system that loosens and relaxes the thoracic tissues. A kind of 'bell' or 'sucker' is placed over the site of the mastectomy and connected to a pump that creates a vacuum, sucking the chest tissues outwards, loosening and softening them. To be effective, this 'bell' should be worn for around 12 hours per day for several weeks, a 'harness' that we judge too restrictive with regards to its benefit.

Types of prosthesis

The prosthetic implant filled with silicone gel is the most popular because it gives better cosmetic results. A few years ago, these kinds of implant raised some concern with the international medical authorities but numerous scientific studies have since confirmed their reliability and safety. Learn more+

There are two kinds of prosthetic implants :

  • Anatomical implants for which you can choose the width, height and projection of the implant.
prothèse anatomique par largeur
  • Round implants for which you can choose the width and projection of the implant.
prothèse anatomique par largeur et projection

We mainly use the anatomical implants made from silicone gel for breast reconstructions and round prostheses for increasing the size of the other breast if necessary.

The tissue expander allows you to gradually stretch the tissues. It is implanted deflated, then, when the skin and muscle have healed, the surgeon injects physiological saline into it via a valve under the skin, to increase the volume.

prothèse d’expansion

The procedure

  • The incision includes a part of the mastectomy scar.
  • The surgeon creates a space behind the pectoral muscle designed to house the prosthetic implant.
  • He creates the inframammary fold (the crease under the breast).
  • The prosthesis is put in place, as well as a drain which will be removed a few days later.
  • The wall is closed.

If necessary, the contralateral (other) breast is operated on. Depending on the case, the surgery consists of increasing the size (breast implants), reducing it or correcting the ptosis (sag) with a breast lift.

Practical details

  • The procedure takes 1.5 to 2.5 hours
  • General anaesthesia.
  • Hospitalisation is for 24 hours (overnight) to one week depending on how far away you live.
  • Pain is usually mild, and is properly moderated with painkillers
  • Dressings stay on for 8 to 10 days.
  • No sport for 1 month.

This procedure is covered by social security for French residents.

Potential complications

  • The introduction of a foreign body brings a risk of infection which is increased by radiotherapy.
  • The scar is an area of weakness. Radiation increases the risk of the wound opening.
  • The implementation of an implant causes the formation of a capsule: a kind of membrane or scar around it which isolates the surrounding tissues. The quality of the reconstruction depends on the suppleness of this capsule. The more rigid it is (creation of a shell), the more fixed the reconstruction will be. Parietal radiotherapy increases the risk of this capsule forming.
 
  • Mastectomy and immediate reconstruction with a prosthesis left and right breast lift

  • Mastectomy and immediate reconstruction with a prosthesis right and right breast prosthesis

  • Mastectomy and immediate reconstruction with a prosthesis left

  • Right by immediate reconstruction prosthesis, prosthesis and breast lift left

  • Delayed left by prosthesis and prosthetic reconstruction and breast lift procedure law

  • Left reconstruction prosthesis

  • Delayed left by reconstruction and breast prosthesis breast lift right

  • Left delayed by prosthesis and reconstruction and breast reduction breast lift right

  • Delayed left by prosthesis reconstruction and right breast reduction

  • Delayed left by prosthesis reconstruction and right breast prosthesis

  • Delayed left by prosthesis and prosthetic reconstruction to increase the right breast

  • Delayed reconstruction left and right breast reduction

  • Delayed by right implant and prosthesis + redrapage left breast reconstruction

  • Delayed by right implant reconstruction and left breast prosthesis

  • Delayed by right implant reconstruction and left breast prosthesis

  • Delayed by right implant reconstruction and prosthesis left

  • Delayed by right implant reconstruction and prosthesis + left breast lift

  • Delayed left by prosthesis reconstruction and right breast reduction

  • Delayed left by prosthesis and prosthetic reconstruction + right breast lift

  • Delayed left by prosthesis reconstruction, prophylactic mastectomy and reconstruction right

  • Delayed left by reconstruction and breast prosthesis breast lift right

  • Delayed left by prosthesis and prosthetic reconstruction + right breast lift

  • Delayed by right implant and prosthetic reconstruction and breast lift left

  • Delayed by right implant reconstruction

  • Delayed right and left by prosthetic and left reconstruction

  • Delayed left by reconstruction and breast lift and implant prosthesis right

  • Delayed left by prosthesis reconstruction

  • Delayed by right implant reconstruction

Secretary of Dr I. Sarfati

Phone : 01 45 63 01 02

If your inquiry is urgent, we recommend that you send sms to 06 52 63 06 32 or mail to secret.is@idsein.fr