Risks – Expander and Implant Breast Reconstruction

Multi-staged process

• Your breast reconstruction will be undertaken over three to four stages.
• Each stage is spaced approximately 3 months apart.
• Each stage becomes increasingly less demanding.
• The entire process usually takes approximately 1 year. The process is fairly flexible such that the stages can be organized to fit your life and your schedule.

Life and breast reconstruction

• Your life will not be put on hold for the duration of your breast reconstruction. Instead it will be punctuated by a series of procedures with relatively normal life in between.

Relationships and breast reconstruction

• First and foremost, this surgery is for you. However, having multiple surgeries spaced over 1 year can also be difficult for those around you. It is important to think about and discuss the process with your partner or support person.
• The process will have immediate effects on your
  • Partner
  • Children
  • Work relationships
• It is healthy and important that you think about these issues and formulate pre-emptive strategies to help you through your breast reconstruction.

The risks associated with this form of breast reconstruction are related to your general health and the presence of co-existing medical conditions.

• Smoking
• Diabetes
• BMI (body mass index)
• Massive weight loss (>20kg)
• Immuno-suppression.

• Pain and discomfort
• Bleeding
• Infection
• Delayed wound healing
• Seroma

You may have a general anaesthetic at one of several major hospitals in Adelaide or a “twilight” anaesthetic in a day surgery.

Your anesthetist will outline the process and the risks of anaesthesia prior to your procedure.

Some risks to consider are

• DVT
• Chest infection
• Anaphylaxis
• Injury to teeth

Expander related risks

• Discomfort and tightness
• A sensation of tightness for approximately 24 hours after each expansion. This is usually easily controlled with paracetamol.
• Deflation or puncture
• Irregularity
• Asymmetry
• Palpability

Implant related risks

• Palpability
• Malposition
• Rotation
• Rippling
• Capsular contracture
• Rupture
• Anaplastic Large Cell lymphoma

Changes to sensation

• Your reconstructed breast will have diminished and altered sensation that may be patchy in nature.
• You may feel a sense of fullness to the side of your breast due to the change in sensation

Scarring

• Normal, hypertrophic, keloid

Aesthetic

• Bilateral reconstruction
  • Asymmetry of size and shape
• Unilateral reconstruction
  • Asymmetry of size and shape
  • Lack of ptosis or sagging on the reconstructed side may make it difficult to mimic the un-operated breast
  • Reconstructed breast will be firmer and less mobile than the un-operated breast

• Recurrence of asymmetry related to ageing, weight changes, skin laxity and implant related issues
• Revisional surgeries related to recurrence of asymmetry and implant related issues