How do doctors restore a woman's breast with implants?

• After the mastectomy, implants are placed beneath the skin or the chest muscle. (The majority of mastectomy procedures are carried out using a technique termed skin-sparing mastectomy, in which a significant portion of the breast skin is preserved for use in breast reconstruction.)

• Typically, implant placement involves two stages.

• Under the skin that is still there after the mastectomy or behind the chest muscle, the surgeon inserts a tool known as a tissue expander as the initial step (1,2). Following surgery, the expander is gradually filled with saline during routine doctor appointments.

• The expander is taken out and replaced with an implant in the second stage after the chest tissue has relaxed and healed sufficiently. After a mastectomy, the chest tissue is typically prepared for the implant 2 to 6 months later.

• In some instances, the mastectomy and implant placement can be done simultaneously, meaning that a tissue expander is not necessary to prepare the breast for the implant (3).

• Acellular dermal matrix is a substance that surgeons are increasingly using as a scaffold or "sling" to support implants and tissue expanders. Acellular dermal matrix is a type of mesh created from donated skin from pigs or humans that has been sterilised and processed to remove all cells in order to reduce the risk of infection and rejection.

Back and abdominal flaps include:

1. DIEP flap: Tissue that solely consists of skin, blood vessels, and fat and lacks the underlying muscle comes from the abdomen. A free flap is this kind of flap.

2. Tissue arises from the centre and side of the back in the latissimus dorsi (LD) flap. If this kind of flap is utilised for breast reconstruction, it is pedicled. (LD flaps can also be utilised for different kinds of reconstruction.)

3. SIEA flap (also known as SIEP flap): Similar to a DIEP flap, tissue is taken from the abdomen, but a different set of blood vessels are present. Additionally, because it is a free flap, no abdominal muscles are severed during it.

For women who have undergone substantial abdominal surgery in the past or who lack enough abdominal tissue to reconstruct a breast, flaps obtained from the thigh or buttocks are employed. These flaps are examples of free flaps. An implant is frequently utilised in conjunction with these flaps to produce adequate breast volume.

1. IGAP flap: Only skin, blood vessels, and fat are present in the tissue that comes from the buttocks.

2. PAP flap: Muscle-free tissue that originates from the upper inner thigh.

3. SGAP flap: Similar to an IGAP flap, SGAP flap tissue is derived from the buttocks but comprises solely skin, blood vessels, and fat.

4. TUG flap: Muscle and other tissue from the upper inner thigh.