Breast reconstruction - implant with collagen mesh

Implant only
If you are looking for information about cosmetic breast augmentation/enlargement rather than breast reconstruction following mastectomy, please click here.

When a mastectomy for breast cancer is necessary, a patient may wish to explore their options for an immediate reconstruction. Implant-based breast reconstruction can be achieved using a collagen mesh (also known as acellular dermal matrix, ADM).

The mesh is used to create an "internal bra" to support the lower part of the implant and hold it in position. The upper part of the implant is placed under the pectoralis major muscle. Coverage of the implant in this way helps to keep it in the correct position and to take the weight of the implant and allow the overlying skin wound to heal successfully.

More recently, a pre-pectoral technique has been introduced, in which a larger piece of ADM is used to cover the entire implant rather than just the lower part. Covering the whole implant means that the pectoralis major muscle does not have to be disturbed and reduces the likelihood of "animation", where the muscle can cause the implant reconstruction to twitch or move. The video clip on the left shows the Braxon ADM being prepared in the operating theatre before being placed into the mastectomy pocket.

There are a range of ADMs on the market, amongst the most commonly used are StratticeTM from LifeCell and SurgiMendTM from Integra. LifeCell have released an improved version of Strattice in 2016, called ArtiaTM. Miss Kaushik and Mr Pilgrim were among the first UK surgeons to use Artia. Braxon® is the ADM used for the pre-pectoral technique. 

Implant based immediate breast reconstruction can be performed as a one- or two-stage procedure. In a one-stage procedure, the surgeon will place a definitive silicone-filled implant; whereas in a two-stage procedure an expandable saline-filled implant is placed and subsequently exchanged for the definitive implant some months later.

To discuss which reconstructive option might be suitable for you, please contact us to arrange a consultation with a  Consultant Oncoplastic Breast Surgeon at Breast Care Leicester .
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