ABSTRACT
Breast reconstruction using implant devices is a standard technique which can be undertaken as either an immediate or delayed procedure following mastectomy. As a form of immediate reconstruction it is a simpler procedure compared with reconstructive methods involving transfer of myocutaneous flaps which constitute more complex surgery. Most patients undergoing mastectomy are eligible for immediate reconstruction, even when the primary breast tumour has unfavourable characteristics and prognosis is limited. Patients should be jointly assessed by both plastic and general surgeons prior to surgery in order to plan the site of surgical incisions and select an appropriate implant. Prostheses can be either temporary or permanent and expansile devices are now available which can remain permanently once expansion is complete. Newer tissue expanders have a thick silicone envelope and a central chamber filled with saline, and are preferable to the thin walled saline filled implants used in the past which can lead to a ‘rippling’ effect. Some prostheses are biodimensional in an attempt to reproduce the natural ptosis of the breast and avoid excessive fullness in the upper quadrants. A tissue expander device is suitable for more than 90% of cases and is a popular choice of implant.
