Breast implant reconstruction has become the most common form of breast reconstruction today. Although direct to breast implant reconstruction is the preferred technique thus eliminating a two-stage procedure, there are several problems encountered.
If mastectomy flaps are thin and circulation threatened, the pressure of the implant could cause circulatory problems.
The volume of the implant cannot be adjusted post operatively resulting in a higher incidence of asymmetry.
Alternatively, tissue expanders can be used at the time of the mastectomy requiring a second procedure to exchange the expander with a silicone gel implant.
The adjustable implant offers an alternative, the ability to perform immediate reconstruction with an implant that can initially function as a tissue expander and allow for postoperative volume adjust adjustment. And then convert to the definitive implant once the injection port is removed.
Adjustable implants are available in a variety of forms including single lumen saline, double lumen, containing 25% silicone and 50% silicone gel and anatomical.
The implants can be placed under filled initially with the injection port placed subcutaneously, allowing for postoperative expansion and volume adjustment. The injection port is then removed at the later stage under local anaesthetic.
Alternatively, the injection port can be exteriorized through a long subcutaneous tunnel, and left in place for a few days, allowing early postoperative volume adjustments.
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