Breast reconstruction by prosthesis

This breast reconstruction aims to reconstitute the volume and contours of the breast by fitting a prosthesis. It is the simplest technique, creating no additional scars. Dr. Santini offers this method of breast reconstruction surgery in Paris only on supple, well-vascularized skin.

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Breast reconstruction with prostheses in Paris | Breast reconstruction surgery | Dr Santini

What are the indications for breast reconstruction by prosthesis in Paris?

There are two main causes of breast volume loss leading to breast reconstruction with breast implants:

  • accidental tissue loss, such as major trauma or burns: this is the rarest situation.
  • voluntary tissue loss for therapeutic purposes, generally following excision surgery for breast cancer (mastectomy or mammectomy).

Dr Christelle Santini offers this aesthetic and natural solution, provided that the superficial enveloping tissues (skin, subcutaneous tissue, etc.) are healthy and supple. Otherwise, the prosthesis must be combined with a dorsal flap, or an autologous flap such as the DIEP.

The choice of breast implants will most often be a breast implant filled with high-density silicone gel, whose absence of health risk is now well established. The breast prosthesis is either round or anatomically shaped (drop-shaped), and its surface is "textured", i.e. irregular and grainy to reduce the risk of displacement.

This choice takes into account the morphology of the contralateral breast.

In some cases, a temporary tissue expansion prosthesis designed to increase the amount of covering tissue (skin, muscle) can be fitted before the permanent prosthesis, to give a more natural appearance to the reconstructed breast with elastic, sufficiently distended skin.

This is called an expander, and is progressively inflated with saline over several months (often 4 to 6).

What should I do before undergoing breast prosthesis reconstruction?

The preliminary consultation enables Dr. Santini to verify the indications, based on the clinical examination and the patient's expectations. Smoking cessation is recommended one month before and one month after the operation (smoking can delay healing).

No aspirin-containing medication should be taken for 10 days prior to surgery.

Medical photos are taken to ensure tailor-made follow-up.

What is the procedure for breast reconstruction with a prosthesis?

This breast reconstruction surgery is performed under general anesthesia and lasts approximately one to two hours. The mastectomy scar is opened, thus avoiding the need for an additional scar.

The prosthesis is inserted into a cavity created under the pectoralis major muscle, against the ribs. This retro-muscular implant placement ensures good contention of the implant, without exerting pressure on skin tissue that has often suffered. A final drain may be used to aspirate post-operative discharge, reducing the risk of hematoma.

What to do after breast prosthesis reconstruction?

Due to distension of the pectoralis major muscle by the prosthesis, pain can sometimes be significant in the first few days. This pain is systematically managed as a preventive measure, adapted to your specific case. As with any operation, there is a risk of complications.

The first bandage is usually removed the day after the operation, and replaced by a support bra, without underwiring, that opens at the front. This is particularly important to prevent the prosthesis from moving upwards. The bra must be purchased before the operation and worn day and night for at least a month. The drain is removed if necessary between the second and eighth days, but its presence does not prevent you from leaving the hospital on the second day if your condition allows: you will return for a consultation to have it removed.

In the case of skin expansion, pain is minimal and a bra is not essential. However, it will be necessary during the second stage of surgery.

What is the result of breast reconstruction with a prosthesis?

The volume of the reconstructed breast is supple and firm, with little mobility and a "youthful" appearance.

The result is very natural, especially with a pear-shaped anatomical prosthesis. A second operation may be required a few months apart to symmetrize the contralateral breast and reconstruct the areola and nipple. reconstruct the areola and nipple.

Highlights of breast reconstruction with prostheses

  • Tailor-made results
  • One night at the clinic and 4 to 7 days of professional downtime
  • Final result at 6 months

Breast reconstruction with breast implants in brief...

What should I do before undergoing breast reconstruction with a prosthesis?

  • 1 to 2 consultations with your plastic surgeon, including the taking of medical photographs
  • Delivery and signature of the estimate, including at least 15 days between the first consultation and breast implant placement
  • Anesthesia consultation, blood and oncology check-ups
  • Choice of the most suitable prosthesis with your surgeon, taking into account the morphology of the other breast.

How does breast reconstruction with implants work?

  • General anesthesia.
  • 1h to 1h30 of surgery for a retro-muscular breast prosthesis.
  • Overnight hospital stay
  • Approach via the mastectomy scar
  • We give you a card with the references of the breast implants fitted.

What is the post-operative course of breast reconstruction with implants?

  • Wear a medical compression bra for 4 to 6 weeks.
  • 7-day leave after breast prosthesis insertion
  • Follow-up visit with your plastic surgeon 7 to 10 days after the procedure (absorbable threads).
  • Take a break from sport for at least a month and a half.
  • Final result obtained after a minimum of 6 months, UV protection of the scar for 12 months.
  • Follow-up consultation to monitor breast prostheses for one year, then every two years.

Associated treatments