Name of the Procedure:

Prosthesis, breast (implantable)
Common Names: Breast Implant, Breast Augmentation
Technical Term: Breast Prosthesis Implantation (C1789)

Summary

Breast implant surgery involves placing a gel-filled or saline-filled prosthesis under the breast tissue or chest muscles to enhance breast size or reconstruct the breast after mastectomy or injury. The procedure can help improve the shape and size of breasts, leading to a more symmetrical and natural appearance.

Purpose

Medical Conditions/Problems Addressed:

• Breast cancer requiring mastectomy
• Congenital breast deformities
• Post-traumatic breast reconstruction
• Cosmetic enhancement for small or asymmetrical breasts

Goals/Expected Outcomes:

• Improved physical appearance and symmetry
• Enhanced self-esteem and confidence
• Restoration of normal breast contour and volume

Indications

Specific Symptoms/Conditions:

• Loss of breast tissue following mastectomy
• Congenital anomalies or deformities of the breast
• Desire for increased breast size for cosmetic reasons

Patient Criteria:

• Good overall health and stable weight
• Non-smokers or willing to quit smoking before surgery
• Realistic expectations about the outcomes

Preparation

1. Pre-Procedure Instructions:

   • Fasting 8-12 hours prior if general anesthesia is used
   • Temporary cessation of certain medications, as advised by the surgeon
   • Avoiding alcohol and smoking weeks before surgery

2. Diagnostic Tests/Assessments:

   • Pre-operative mammogram (for patients over 40 or those with a family history of breast cancer)
   • Blood tests and a physical examination
   • Consultation and measurement for implant selection

Procedure Description

1. Steps Involved:

   • Administration of anesthesia (general or local with sedation)
   • Incision made in one of several possible locations: under the breast, around the nipple, or in the armpit
   • Creation of a pocket to place the implant either under the breast tissue or chest muscle
   • Insertion of the implant into the pocket
   • Closing incisions with sutures, skin adhesives, or surgical tape

2. Tools/Equipment Used:

   • Surgical scalpel, retractors, breast implants (silicone gel or saline)

3. Anesthesia/Sedation Details:

   • General anesthesia or local anesthesia with sedation

Duration

The procedure typically takes 1 to 2 hours.

Setting

Breast implant surgery is usually performed in a hospital, outpatient surgical center, or specialized cosmetic surgery clinic.

Personnel

• Board-certified plastic surgeon
• Anesthesiologist
• Surgical nurses and assistants

Risks and Complications

Common Risks:

• Infection
• Bleeding and hematoma
• Capsular contracture (scar tissue formation around the implant)

Rare Risks:

• Implant rupture or leakage
• Permanent changes in nipple or breast sensation
• Anaplastic large-cell lymphoma (ALCL), a rare cancer associated with implants

Management:

• Antibiotics for infections
• Follow-up surgeries for complications like capsular contracture or implant rupture

Benefits

• Improved breast symmetry and volume
• Natural-looking results that enhance body contour
• Immediate improvement in appearance post-surgery, with full results in a few months

Recovery

Post-Procedure Care:

• Wearing a support bra or compression garment
• Pain management with prescribed medications
• Avoiding strenuous activities and heavy lifting for 4-6 weeks

Expected Recovery Time:

• Initial recovery in 1-2 weeks
• Full recovery and final results in 2-3 months

Follow-Up Appointments:

• Regular follow-ups with the surgeon to monitor healing and implant condition

Alternatives

Other Treatment Options:

• Breast reconstruction with autologous tissue (flap procedures)
• External breast prostheses (non-surgical)

Pros and Cons of Alternatives:

• Flap procedures: longer surgery and recovery time, but no foreign material implanted
• External prostheses: non-invasive but less natural and can feel cumbersome

Patient Experience

During the Procedure:

• Under anesthesia, the patient will feel no pain

After the Procedure:

• Mild to moderate pain managed by prescribed painkillers
• Swelling, bruising, and temporary soreness in the breast area
• Possible emotional adjustment period as the patient adapts to their new appearance

Pain Management & Comfort:

• Use of medications for pain relief
• Following all aftercare advice to minimize discomfort and promote healing

This markdown serves as a comprehensive guide for patients considering or preparing for breast prosthesis implantation surgery, offering clarity on every aspect of the procedure.