Breast Reconstruction with Implants and Expanders

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Abstract
Learning Objectives: After studying this article, the participant should be able to: 1. Assess the suitability of a patient for prosthetic reconstruction. 2. Understand the principles of dimensional planning for implant and expander selection. 3. Discuss the advantages and disadvantages of immediate versus delayed expander/implant reconstruction. 4. Apply the surgical techniques of immediate and delayed expander/implant reconstruction. Breast reconstruction with expanders and implants provides an excellent option in the properly selected patient. Techniques for reconstruction have evolved significantly over the past 30 years with the development of more sophisticated devices and improvement in surgical procedures. Several options exist, each with its own advantages and disadvantages. Two-stage breast reconstruction using a textured device with an anatomic shape and integrated valve seems to provide the most consistent and reproducible results in most patients. Those patients with small, minimally ptotic breasts may be candidates for either single-stage implant reconstruction or reconstruction with an adjustable device. Advantages of expander and implant reconstruction over other techniques include relative ease of the procedure; no distant donor-site morbidity; use of tissue of similar color, texture, and sensation; reduced operative time; and more rapid postoperative recovery. (Plast. Reconstr. Surg. 107: 177, 2001.)