Phoenix plastic surgeons Dr. Tessler and Dr. Turin are specialists in implant based breast reconstruction procedures. The surgeon aims to help women who have battled the scourge of cancer feel whole again after a mastectomy or lumpectomy. Dr. Tessler and Dr. Turin have worked with numerous breast cancer survivors from Phoenix, Scottsdale, Gilbert, Mesa, Glendale, Paradise Valley, and surrounding AZ cities. The surgeon takes each patient case as unique and works to develop a customized reconstruction plan to suit their goals.
Who is a candidate for Implant Breast Reconstruction?
Implant breast reconstruction entails using synthetic implants with a long shelf life to form a new breast form for women who have undergone a mastectomy. You may be an ideal candidate for this breast reconstruction technique if:
- You are able to cope with your cancer diagnosis and treatment
- You do not have additional health issues that can interfere with healing
- You have realistic expectations for restoring your breast and body image
- You lack sufficient tissue in your body to undergo flap reconstruction
- You do not desire the lengthy procedures, multiple incisions, and prolonged recovery time needed with flap breast reconstruction
During your breast reconstruction consultation with Dr. Tessler or Dr. Turin, the surgeon will listen to your concerns, examine your body, and study your medical history before letting you know whether implant reconstruction can be beneficial to you. If your body type or medical history does not permit this procedure, Dr. Tessler and Dr. Turin will recommend an alternative breast rebuilding technique that suits your profile.
Types of Breast Implants
Dr. Tessler and Dr. Turin have two main types of breast implants that he can use to perform the reconstruction surgery:
- Saline implants – these constitute a silicone shell that is filled with a sterilized saltwater solution. These implants are FDA-approved for use on women above the age of 18. They are usually inserted empty and then later filled with the saline solution to suit the patient’s desired breast shape and volume. Saline implants are more affordable than silicone implants, but are more prone to complications such as rippling and wrinkling.
- Silicone gel implants – these implants are more widely used in breast reconstruction procedures than silicone implants. They constitute a silicone shell that is pre-filled with a silicone gel. Silicone implants tend to result in a more natural breast feel, and are FDA approved for use on women above the age of 22. Some variations of silicone implants – referred to as form stable implants – contain a thicker silicone gel and retain their shape even if the shell is broken.
Breast implants come in all sorts of shapes and sizes. Dr. Tessler and Dr. Turin are uniquely positioned to help you select the best implant type and brand for your breast reconstruction. The surgeon puts into consideration various factors such as your desired breast size, skin elasticity, and body frame when recommending an implant type to suit your goals.
Implant Reconstruction Procedure Types
Breast reconstruction can be performed at the same time as the mastectomy (direct to implant) or at a later date (delayed reconstruction).
Direct to Implant Reconstruction (one-step reconstruction)
This type of procedure is either done or at least started, at the same time as the mastectomy. The surgeon will position the implant either below or above the pectoral chest muscle. In some cases, an absorbable mesh will be used to hold the implant in place. The benefits of immediate reconstruction are that it preserves breast skin, which can result in a better-looking outcome. Women also do not need to stay without a breast shape after their mastectomy, which can provide some form of encouragement during recovery. While the first step is often the major one, many other steps are needed in order to refine the breast shape and appearance. Dr. Tessler and Dr. Turin will discuss the pros and cons of direct to implant breast reconstruction and help you understand whether this is the right procedure choice for you.
Delayed Reconstruction (two-step reconstruction)
This means that reconstruction of the breast is initiated later after the cancer surgery is completed. Your surgeon will insert a short-term tissue expander during the mastectomy to pave the way for reconstructive surgery later. This expander is a balloon-like sac that is inserted empty and then inflated to the desired size to allow your skin to stretch. Once the skin has stretched enough to accommodate an implant, a second procedure will be performed to insert the implant. Two-step breast reconstruction makes it possible for other cancer treatment options to be explored. While the expander can be filled (inflated) during chemotherapy, the final implant placement is only done once radiation treatment is complete. If radiation treatment is not needed, then the surgeon can start filling the expander immediately after surgery.
Reasons to delay Breast Reconstruction
There are various reasons why you may choose to delay your breast reconstruction:
- You want to cope with the cancer treatment first – many women prefer to deal with the cancer surgery treatment first then think about breast reconstruction later.
- You have additional health problems – other health conditions may make it necessary to delay your reconstruction breast surgery. Particularly, individuals who smoke are required to quit for at least 2 months in advance in order to allow for better healing after the reconstructive surgery.
- You need radiation treatment – Dr. Tessler and Dr. Turin recommend that patients who need radiation cancer treatment delay their breast reconstruction. This is so because radiation can pose a number of problems after surgery, including scarring, delayed healing, and lower chances of success. Flap breast reconstruction is almost always delayed until after the radiation treatment.
Pros and Cons of Implant Based Breast Reconstruction
- Involves a shorter and less complex surgery
- Does not create new incisions (mastectomy incision is used for the reconstruction procedure)
- Can be completed at the same time as the mastectomy
- The size of the reconstructed breasts does not change when the patient loses or gains weight
- Easy to find surgeons who can perform implant breast reconstruction
- Multiple office visits, steps, and procedures may be needed to complete the overall reconstruction process
- Result does not look or feel as natural as with flap breast reconstruction
- Risk of implant complications such as rupture, capsular contracture, and deflation
- Additional surgery may be needed to balance achieve symmetry of both breasts
- Not a great option for skin that has undergone radiation
Recovery after Implant Reconstruction
Dr. Tessler and Dr. Turin will provide precise instructions that you need to adhere to for your recovery. These will include detailed info on the types of light exercises you need to engage in in order to build-up scar tissue and stiffness after one-step or two-step implant reconstruction. You will also be told how to care for your dressings, staples, stitches, and surgical drains. It takes up to 6 weeks (or more) for patients who have received direct-to-implant surgery to recover. The surgeon will provide pain medication to improve your comfort level, as well as antibiotics to prevent an infection. It is important that you put aside time for rest, and engage in the recommended light exercises throughout the recovery stretch. You will be restricted from engaging in any form of strenuous activities until after you get the go-ahead from the surgeon. Swapping of the tissue expander (the second step of delayed implant reconstruction) is performed in Dr. Tessler and Dr. Turin’s in-office operating room on an outpatient basis. Keep in mind that you will still need to be sedated and need someone to drive you home from the clinic. This part of implant reconstruction surgery takes about 2 hours to complete and most patients can expect to recover in 2-4 weeks.
Risks of Breast Implants
In July 2019, the FDA requested a recall of Allergan’s Biocell textured breast implants and expanders. This followed a study linking a rare type of cancer known as ALCL (Anaplastic Large-Cell Lymphoma) to textured breast implants. Dr. Tessler and Dr. Turin does not use the affected type of implant and any other implant brand or type whose safety is not above board. The surgeon puts great emphasis on safety and will take his time to discuss implant options and the most beneficial and healthy breast reconstruction techniques. Dr. Tessler and Dr. Turin utilize advanced surgical methods to deliver an optimal outcome while minimizing the risk of common implant complications such as capsular contracture, rippling, malpositioning, and bottoming out.
Health Insurance Coverage for Implant Reconstruction
The Women’s Health and Cancer Rights Act (WHCRA) of 1998 requires all group health insurance plans that pay for mastectomy to also cover all stages of breast reconstruction, including corrective procedures, insertion of prosthesis, as well as post-mastectomy lymphedema. Your health insurer should pay for breast reconstruction, whether it is done at the same time as the mastectomy/lumpectomy, or years later. This includes reconstruction procedures that may be needed over time to improve the reconstructed breast or create a balance between the two breasts. Keep in mind though that government and church-sponsored plans are not always required to cover reconstruction, so you may need to check with your insurance provider.
Schedule your Implant Breast Reconstruction in AZ
Working with a highly experienced, board-certified plastic surgeon is the first step towards ensuring a successful breast reconstruction procedure. Dr. Tessler was appointed assistant and associate professor of Plastic Surgery at Louisiana State University and Tulane University. He has also served as Director of Plastic Surgery at University Medical Center, as well as contributed important research in the field and trained dozens of the upcoming plastic surgeons. Dr. Tessler’s passion lies in restoring form and function while improving the quality of life of his patients. He brings a friendly and personalized approach to reconstruction surgery while working with highly qualified anesthesiologists and other support staff who strive to deliver the best implant reconstruction surgery Phoenix, AZ has to offer. Get in touch with Tessler Plastic Surgery to schedule your first appointment today.