Two-Stage Implant Reconstruction

After mastectomy there are many types of breast reconstruction procedures possible. If you choose implant-based reconstruction, implants may be placed immediately at the time of mastectomy or during a two-staged surgery. During the first phase, a tissue expander is placed to create a stable envelope for the final implant; during the second surgery, the implants are placed and additional fat grafting and final breast contouring are performed.

What is two-stage implant reconstruction?

Two-stage implant reconstruction consists of an initial phase during which the surgeon will prepare the breast cavity to properly receive an implant. This envelope is created by placing a tissue expander into the capsule. The tissue expander is made of silicon and resembles a small balloon. It contains a port through which the doctor can add saline over the course of a few weeks. As the tissue expander is gradually enlarged, the capsule within the chest widens, making room for the appropriate-sized implant.

The second stage of reconstruction will occur two to three months after the first stage. There are many reasons to start with an expander, rather than going directly to an implant. For example, for women who need a small breast lift, the expander can be used to mold the skin envelope, allowing for better final position of the implant.

In the second stage of implant reconstruction, the tissue expander is removed from the chest and replaced with a breast implant. Prior to the placement of implants, you and the doctor will have decided upon the type of implant and location of implant above or below the pec muscles. If necessary, Dr. Zampell will perform an additional surgery to fat graft the breast for a smoother, softer and more natural appearance.

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What are the benefits of two-stage implant reconstruction?

More time to consider the options for restoration
Larger cup size can be achieved with implants
Greater ability to manipulate breast skin envelope and breast size

Lowered risk of complications
Increased breast symmetry
Possible reduction in morbidity

Who makes a good candidate for two-stage implant reconstruction?

Women who have larger breasts or more breast ptosis (sagging) of the breasts may benefit from a temporary expander. This allows the breast skin envelope to shrink and mold around the expander, to achieve a smaller, lifted breast.

Women who have a higher chance of mastectomy skin flap necrosis or thin skin may be approached more safely with a temporary expander than with immediate implant. The decision of how to approach your implant reconstruction is a highly personal one, and this can be discussed in detail with Dr. Zampell during a private consultation. Rest assured you will receive all the information you need to make an empowered decision that is right for you.

What can I expect from my recovery?

You may experience some aching and bruising for the first few weeks. You will receive prescriptions for both antibiotics and painkillers from Dr. Zampell. Heavy lifting and rigorous activity should be avoided for at least two weeks after surgery. Most patients are completely recovered by six weeks, but this will depend on your personal healing ability. It's never a good idea to rush recovery, so you should stay in close contact with the doctor to determine the best time for your return to work.

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Why choose Dr. Zampell in Beverly Hills for two-stage implant reconstruction?

Dr. Zampell is an industrious and intuitive breast reconstruction surgeon who brings serenity and hope to her patients who have suffered with breast cancer, restoring their quality of life as well as their appearance. She has trained extensively under some of the brightest luminaries in the field such as Dr. Robert Allen, creator of many autologous flap techniques used around the world today. Dr. Zampell has created a compassionate practice setting that focuses on the individual, tailoring each procedure to their wishes and aesthetic sensibilities.

After graduating with honors from Ohio State University College of Medicine, Dr. Zampell went on to complete a demanding residency in plastic and general surgery at the NYU Medical Center, one of the highest regarded institutions in the industry. After this, she continued to hone her skills with a challenging fellowship in microsurgery at the University of California Los Angeles.