Dr. Marga is a board certified Plastic Surgeon with additional training as a Certified Lymphedema Therapist. She is the Founder of the National Institute of Lymphology and serves as a Medical Advisor to the Norton School. Dr. Marga promotes the the highest standard of lymphedema care for surgical patients nationwide.
Single Stage Permanent Saline/Silicone-Filled Breast Implant
Patients may be offered skin sparing mastectomies as a part of their coordinated patient care plan. In this setting, a permanent saline or silicone-filled breast implant may be placed under the pectoralis major muscle if Alloderm™ is used in order to create an internal bra. This procedure requires general anesthesia and can typically be completed in 2 hours. Patients remain in the hospital overnight and are treated with intravenous pain medications with conversion to pain pills and muscle relaxants on the day following surgery. 2 surgical drains are placed in the reconstruction site and are maintained up to 14 days.
This type of reconstruction requires the highest level of post-operative outpatient surveillance – you will be required to stay local to Dr. Massey for 14-21 days post-operatively before release for travel to home.
Limitations to this technique include:
a. One must have healthy skin flaps at the time of skin sparing mastectomy in order to complete this form of single stage reconstruction. Injury to the skin can occur at time of mastectomy that may or may not be apparent in the operating room. If an implant is placed under injured skin, the reconstruction may fail to heal.
Dr. Marga may elect to defer to a tissue expander placement (which is adjustable and will require removal at a second surgery) or no device placement depending on the level of injury to the skin. Patients with significant skin injury at time of mastectomy are likely candidates for delayed breast reconstruction at a later date, typically after the completion of chemotherapy and irradiation if required.
b. You must be pleased with a breast size equal to (total nipple and areolar skin sparing mastectomy) or slightly smaller (skin sparing mastectomy with excision of the nipple and areola) with the exception of patients with significant ptosis and excess skin.
Dr. Marga would be pleased to discuss this technique with you in the setting of your individualized consultation as photographs and phone call consultations likely are not an adequate substitute for a physical examination for this highly specific form of breast reconstruciton.
All patients requesting immediate implant placement or "Single Stage" implant breast reconstruction must be seen in Dr. Marga's office at least 2 weeks prior to a planned surgical date in order to complete their silicone-filled implant educational series.