19340 Insertion of breast implant on same day of mastectomy (ie, immediate)

Name of the Procedure:

Insertion of Breast Implant on Same Day of Mastectomy
Common Name(s): Immediate Breast Reconstruction, Same-Day Breast Implant

Summary

The immediate insertion of a breast implant involves placing a breast implant directly after a mastectomy (breast removal surgery). This procedure allows the patient to start the reconstruction process simultaneously, avoiding multiple surgeries.

Purpose

This procedure addresses breast cancer or other breast diseases requiring mastectomy. The goals are to remove the affected tissue and begin the reconstruction in one surgical session. Expected outcomes include restoring the breast’s shape and appearance soon after removal.

Indications

• Diagnosed with breast cancer requiring mastectomy.
• Preventive mastectomy for high-risk patients.
• Desire for immediate reconstruction post-mastectomy.
• Good overall health and suitability for anesthesia.

Preparation

• Pre-surgery fasting as instructed, usually starting the night before.
• Medication adjustments may be advised.
• Preoperative diagnostic tests, such as blood work and imaging.
• Consultation with the surgical team and discussing the procedure in detail.

Procedure Description

1. Anesthesia: General anesthesia is administered.
2. Mastectomy: The surgeon removes the breast tissue.
3. Implant Placement: After mastectomy, a pocket is created in the chest for the implant.
4. Insertion: The breast implant, either silicone or saline, is inserted into the pocket.
5. Closure: The incisions are closed with sutures, and dressings are applied.
6. Monitoring: Patient is monitored in recovery before being moved to a hospital room.

Duration

The procedure typically takes 2 to 4 hours.

Setting

Performed in a hospital operating room where comprehensive surgical and postoperative care is available.

Personnel

• Surgeon: Performs the mastectomy and implant insertion.
• Nurses: Assist during surgery and provide postoperative care.
• Anesthesiologist: Manages anesthesia and monitors the patient’s vital signs.

Risks and Complications

• Infection
• Bleeding or hematoma formation
• Implant complications (e.g., rupture, leaking, capsular contracture)
• Scarring or delayed wound healing
• Anesthesia-related risks

Benefits

• Immediate start of breast reconstruction; avoids a second surgery.
• Possibly better psychological outcomes due to immediate restoration of breast shape.
• Reduced overall recovery time by consolidating surgeries.

Recovery

• Pain management through prescribed medications.
• Follow-up appointments for wound care and monitoring.
• Restrict heavy lifting and strenuous activities for several weeks.
• Full recovery typically takes 4 to 6 weeks.

Alternatives

• Delayed Breast Reconstruction: Reconstruction at a later date after mastectomy.
  • Pros: Allows for cancer treatment completion; longer recovery for better planning.
  • Cons: Multiple surgeries; extended overall recovery time.
• Autologous Tissue Reconstruction: Using the patient’s tissue for reconstruction.
  • Pros: More natural feel; no implant risks.
  • Cons: Longer surgery and recovery; more complex procedure.

Patient Experience

During the procedure, patients will be under general anesthesia and will not feel pain. Postoperatively, they may experience soreness, swelling, and discomfort, managed with pain relief medication. Supportive care, such as wearing a surgical bra and avoiding strenuous activities, enhances comfort and promotes healing.