The history of breast reconstruction is an interesting one, and it greatly influences today's practices. Breast reconstruction really came into its own in the 1970's. At that time, silicone breast prostheses had become very popular. However, the design of these early models left quite a bit to be desired. Complications with hardening and rupture became very troubling. Earlier saline filled implants also suffered from early deflation. Implant problems reached a head in the 1980's when silicone implants were recalled and restricted.

It was at this time, that some very ingenious surgeons developed the concept of using a piece of the patient's body to accomplish the reconstruction. The TRAM flap, which uses the skin and fat of the abdomen was born. These procedures created very lifelike breasts, but their performance was often physically challenging to the patient. The results were very surgeon specific and complications ranging from poor shape to loss of the flap were still a problem.

However, on the horizon were new techniques which took the best from what we had learned in the past, and applied this in a different manner. Tissue expansion emerged as a good alternative to the much more rigorous flap procedures, thus expanding the possibility of reconstruction to a larger population of women.

Tissue expansion techniques offer women excellent results with the smallest physical investment. By this, we mean that this technique provides the most for the least pain. For example, the typical mastectomy patient could have an expander placed at the time of her cancer surgery. If no radiation therapy is contemplated, the implant is expanded to an agreed upon size. The patient is in charge of the expansion, in that they can come to my office weekly, or when they want, for further expansion. When the appropriate size is reached and chemotherapy is ended, the expander is exchanged for modern silicone gel prosthesis. These new silicone prostheses have been studied by the FDA in breast cancer patients and reliably produce reproducibly great results. We are very enthusiastic about this approach and have seen it work well in a wide variety of patients and body types.

In summary, breast reconstruction has undergone a great deal of change in just two or three decades. Significant recent innovations have made these techniques more available then ever to women of all ages. If you have never considered reconstruction, you may want to hear more about tissue expansion techniques from your plastic and reconstructive surgeon.

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