Implantable breast prosthesis, silicone or equal
HCPCS code
Implantable Breast Prosthesis, Silicone or Equal (L8600)
Name of the Procedure
- Common Names: Breast Implant, Silicone Breast Implant
- Medical/Technical Terms: Implantable Breast Prosthesis, Mammary Prosthesis
Summary
In this procedure, a silicone-based breast prosthesis is implanted to replace breast tissue. It is often used in breast reconstruction after mastectomy or for cosmetic enhancement.
Purpose
Implantable breast prostheses are used primarily for:
- Reconstructing the breast after mastectomy due to breast cancer.
- Cosmetic augmentation to enhance breast size and shape.
- Correcting congenital or developmental breast asymmetry.
The goal is to restore breast appearance, improving body image and self-confidence.
Indications
- Previous mastectomy or lumpectomy.
- Aesthetic dissatisfaction with breast size or shape.
- Congenital or acquired breast asymmetry.
- Corrective surgery following trauma or deformity.
Preparation
- Follow fasting instructions if general anesthesia is used (usually no food or drink after midnight the night before surgery).
- Adjust medications as directed by your healthcare provider, usually avoiding blood thinners.
- Preoperative assessments may include blood tests, mammograms, or other imaging studies.
Procedure Description
- Anesthesia: General anesthesia or local anesthesia with sedation.
- Incision: A small incision is made in one of several possible locations: inframammary (under the breast fold), periareolar (around the edge of the areola), or transaxillary (armpit).
- Pocket Creation: A space or “pocket” is created either under the breast tissue (subglandular) or under the chest muscle (submuscular).
- Implant Insertion: The silicone implant is inserted into the pocket and positioned properly.
- Closing Incisions: Incisions are closed with sutures, and adhesive or surgical tape may be applied.
- Bandaging: The area is bandaged, and a surgical bra may be used to support the breasts.
Duration
The procedure typically takes 1-2 hours.
Setting
Performed in a hospital or an outpatient surgical center.
Personnel
- A board-certified plastic surgeon.
- An anesthesiologist or nurse anesthetist.
- Surgical nurses and possibly a surgical technician.
Risks and Complications
- Common: Pain, swelling, bruising, hematoma.
- Rare: Infection, bleeding, implant rupture or leakage, capsular contracture (scar tissue formation), changes in nipple or breast sensation, anesthesia-related risks.
Benefits
- Improved body image and self-esteem.
- Enhanced breast symmetry and shape.
- Restoration of breast appearance following mastectomy. Benefits can be realized within a few weeks to a few months following surgery, as swelling subsides and tissue heals.
Recovery
- Post-procedure: Wear a supportive surgical bra.
- Pain management with prescribed medications.
- Limited physical activity for several weeks.
- Follow-up appointments for monitoring healing and implant positioning.
- Most patients return to normal activities within 4-6 weeks.
Alternatives
- Saline breast implants: Similar procedures but use saline-filled implants, which have different texture and firmness.
- Autologous tissue reconstruction: Uses the patient's own tissue (e.g., from abdomen or back) for breast reconstruction.
- No surgical intervention: Choosing not to undergo any reconstructive or augmentation procedure, possibly using external prosthetic devices instead.
Patient Experience
During the procedure, the patient will be under anesthesia and will not feel pain. Post-operatively, they may experience discomfort, swelling, and bruising, which can be managed with pain relief medications. Patients can expect a recovery time with limited activity and gradual resumption of normal life.
Effective communication with the healthcare team, proper pain management, and adherence to post-operative care instructions are key elements for a smooth recovery.