Direct to implant reconstruction
One-stage breast reconstruction with implants can only be performed at the time of mastectomy where a permanent implant (saline or silicone) is placed under the pectoralis muscle. A sheet of acellular dermis is used to cover the bottom half of the implant. Acellular dermis is cadaver skin (human donor) which is processed so that all cells are removed so that there is no 'rejection' by the patient. In addition, the chance of transfer of a communicable disease from such a product is very low.
By using acellular dermis, we are able to eliminate the need for the tissue expander thus calling this procedure “one stage”. However this procedure often requires a secondary revision such as fat grafting. Patients who are not candidates for this procedure are those that smoke, have BMIs greater than 31, have large breasts, have had radiation or are needing radiation in the post-operative period.
After the procedure
You should be able to go home the next day, with a one night stay overnight in hospital if we are doing only one side (unilateral) or reconstructing both breasts (bilateral).
Complications include capsular contracture, mastectomy flap necrosis, infection, hematoma, seroma, DVT/PE, wound healing problems, and implant maloposition.