Implant Reconstruction
in Ohio

Implant reconstruction restores breast shape after a mastectomy using a silicone or saline implant. At Midwest Breast & Aesthetic Surgery, our surgeons tailor the reconstruction approach to your anatomy, cancer treatment, skin quality, and personal goals.

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What is Implant Reconstruction?

Prepectoral Breast Reconstruction

Prepectoral reconstruction places the tissue expander or permanent implant above the pectoralis muscle, rather than beneath it. Unlike subpectoral breast reconstruction, this approach leaves the muscle undisturbed, helping preserve its function and avoiding animation deformity—the movement or distortion of the reconstructed breast when the chest muscles flex.

This may be particularly beneficial for patients who require radiation therapy after a mastectomy.

How It Works

Prepectoral reconstruction is completed in stages over several months, with the process carefully paced to allow your body to heal and adapt at each step.

Stage 1:
Tissue Expander Placement

When a staged approach is appropriate, a temporary tissue expander is placed above the chest muscle, often at the time of mastectomy. An acellular dermal matrix (ADM) such as AlloMend may be used to provide additional support.

Stage 2:
Gradual Expansion

Once your incisions have healed, the expander is gradually filled with saline during outpatient visits. This gently stretches the breast skin and allows your body to adapt to the desired size.

Stage 3:
Permanent Implant Placement

Once expansion is complete, the expander is replaced with a permanent saline or silicone gel implant through the original incision.

Two Approaches to Implant-Based Reconstruction

Staged Expander-Implant

This two-stage approach is the most commonly used implant-based method and is suitable for a wide range of patients.

Stage 1:
Tissue Expansion

  • A tissue expander is placed beneath the skin and pectoralis muscle at the time of mastectomy or in a separate procedure
  • 2–3 weeks after surgery, the expander is gradually filled with saline, gently stretching the skin over time to create a pocket for the permanent implant
  • Expansion continues until the desired size is reached

Stage 2:
Implant Placement

  • Once expansion is complete, the tissue expander is removed and replaced with a permanent silicone or saline implant
  • This is typically an outpatient procedure with a shorter, more straightforward recovery

Single-Stage or Direct-to-Implant

In select cases, it is possible to place the permanent implant at the time of mastectomy, bypassing the expansion stage entirely.
Direct-to-implant reconstruction is only possible immediately following mastectomy. It is not an option for delayed reconstruction. Candidacy is carefully assessed at physical examination and in close collaboration with your surgical team.

This approach is best suited for:

  • Patients undergoing skin-sparing or nipple-sparing mastectomy, where much of the breast skin is preserved
  • Patients with smaller cup sizes and excellent skin quality
  • Patients seeking a single-stage reconstructive approach

What Is Acellular Dermal Matrix?

In both staged and direct-to-implant reconstruction, a biologic material called Acellular Dermal Matrix (ADM) is sometimes used to support the implant and optimize outcomes. It is a biologic scaffold derived from animal or cadaveric skin, processed to contain no living cells. It acts as a supportive bridge between the lower edge of the pectoralis muscle and the chest wall, filling the gap created when muscle attachments are released to accommodate the implant.

At Midwest Breast & Aesthetic Surgery, we prefer AlloMend by AlloSource, a uniquely designed, meshed ADM that promotes natural tissue ingrowth and provides smooth, consistent coverage of the expander or implant. Over time, the body’s own cells gradually replace the material, integrating it naturally with no removal required.

Recovery & Results

First Few Days

Rest and limited activity are advised as your body begins to heal.

Week 1-2

Follow-up visits begin; swelling and soreness gradually improve.

Week 2-4

Tissue expansion may begin once your incisions have adequately healed.

Months 2-3

Expansion continues gradually until the desired size is reached.

Long Term

Your reconstructed breast continues to settle and soften as swelling resolves and scars mature.

Long-Term Results

Implant reconstruction is designed to restore breast shape and symmetry with results that can last for many years. Your breasts may continue to change with aging, weight fluctuations, and other factors. For some patients, additional procedures or multiple return visits to their physician may be required to refine results.

Frequently Asked Questions

Prepectoral reconstruction places the implant or expander above the chest muscle, while subpectoral reconstruction places it beneath the muscle. Your surgeon will recommend the position best suited to your anatomy and treatment plan.

A tissue expander is a temporary device used to gradually stretch the breast skin before placement of a permanent implant.

Some patients may qualify for direct-to-implant reconstruction. Candidacy depends on your skin quality, anatomy, mastectomy technique, and treatment plan.

AlloMend is an acellular dermal matrix that may be used to provide additional support around a tissue expander or implant. Your body’s tissue gradually integrates with the material over time.

Yes. AlloMend can be used to support a prepectoral tissue expander or implant when your surgeon determines it is appropriate.

Because the pectoralis muscle is left undisturbed, prepectoral reconstruction may reduce some of the discomfort and muscle-related movement associated with subpectoral reconstruction.

Radiation can affect skin quality and healing and may influence which reconstruction approach is safest. Your surgeon will evaluate your treatment history before making a recommendation.

In some patients, revision surgery can convert a subpectoral reconstruction to a prepectoral position. Your surgeon will assess your anatomy and existing reconstruction to determine whether this is appropriate.

Breast reconstruction following mastectomy is generally covered by health insurance under the Women’s Health and Cancer Rights Act, although individual benefits and coverage requirements vary.

*This page is for educational purposes only and is not a substitute for a consultation with a board-certified surgeon. Every patient is unique, and treatment recommendations and results vary. We encourage you to schedule a consultation with our team to discuss your options.

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If you’re exploring implant reconstruction, we’re here to help you move forward with confidence. Schedule a consultation to discuss your goals and create a personalized treatment plan.

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