Reconstruction with expander or implant

The simplest form of breast reconstruction is the reconstruction with an implant. Breast implants are usually filled with silicone gel. The technical development of implants has progressed so far that silicone gel rarely leaks from the implant. Reconstruction with implants is usually easier than with autologous tissue, but the implant must be replaced over the years.
Reconstruction with an implant is not always the best procedure after removal of the breast, as the remaining skin is often not sufficient. In some cases the skin must first be expanded with the help of a so-called balloon prosthesis (expander) in order to be able to insert a corresponding implant in a further operation. The insertion of an expander or an implant can also be useful as a temporary measure. In this case, the implant serves as a "placeholder" until, for example, a final diagnosis can be made or a specific therapy can be completed.


In a primary reconstruction, i.e. a mastectomy and simultaneous reconstruction with an implant, I will discuss the skin incision with you. In the case of a later reconstruction, the skin incisions are predetermined due to the previous removal of the breast. Before surgery we measure the breast and discuss the size and shape of the implant. It may be necessary to adjust the other breast in order to achieve symmetry. In the first days after the operation, the wound fluid is drained via a tube (drainage). This tube can also remain longer, depending on the amount of secretion.

After Surgery

After reconstruction with implants, we recommend wearing a support bra to avoid displacement of the implant and tension on the scars.


Since an implant is a foreign body, healing can be delayed by wound fluids. The most common problem after breast reconstruction with an implant is capsular fibrosis and capsule shrinkage. The implant is a foreign body and is encapsulated by the body, also called a capsule. As long as this capsule cannot be palpated, no problems occur. However, the capsule can become so tight that it compresses the implant, causing ugly deformations and pain. Unfortunately, it is not possible to predict when and with whom the capsular fibrosis will occur.
Then the implant should be removed and switched to alternative procedures. If irradiation is planned, permanent reconstruction with implants should be avoided, as irradiation leads to an increased rate of capsular fibrosis. Further risks are implant displacement, palpability, swelling and wound fluid accumulation, inflammation or a permanent feeling of tension in the stretched skin. Some patients also report a feeling of cold in the breast. We will discuss all possible risks with you in a consultation.




Please make a consultation appointment in advance. Appointments can be made by telephone, online or e-mail contact.

Prof. Dr. med. Hisham Fansa, MBA
Facharzt für Plastische, Rekonstruktive
und Ästhetische Chirurgie (FMH)
Head of Plastic Surgery

Spital Zollikerberg
Trichtenhauserstrasse 20
CH-8125 Zollikerberg