The insertion of an implant behind or under the breast tissue, to increase its size.
- This procedure may be performed:
- After a subcutaneous mastectomy.
- On a patient whose breasts are asymmetrical.
- For postpartum involution.
- For patient’s who’s smaller than desired (aesthetic).
- The approach may be inframammary, periareolar, or flatable, or filled with gel and saline.
- Supine or modified Fowler’s
- Basic pack with transverse Lap sheet
- Basic plastic tray
- Freeman areolar marker
- Basic procedure tray
- Basin set
- Fiberoptic headlight with light source
- Needle counter
- Breast implant
- Surgical support bra
- The line of the incision is marked.
- A 3-to-4-cm incision is made just above the inframammary crease.
- A percutaneous is developed between the pectoralis fascia.
- A plane is developed between the pectoralis fascia and the posterior capsule of the breast.
- A pocket is created by blunt dissection to accommodate the implant.
- Meticulous hemostasis is obtained, and the implant is inserted andadjusted as needed.
- The subcutaneous flap is approximated, and the skin is closed in a manner preferred by the surgeon.
- The line of the incision is marked circumferentially.
- The incision is made along the inferior border of the areola.
- The subcutaneous tissue is dissected to the inferior border of the breast.
- The retromammary space is enlarged by blunt dissection to accommodate the prosthesis.
- Hemostasis is accomplished, and the prothesis is inserted.
- The inferior border of the breast is sutured to the pectoralis fascia.
- The incision is closed according to the surgeon’s preference.
- The incision line is marked in the axilla.
- A vertical or oblique incision is carried down through the subcutaneous tissue.
- Using blunt dissection, a pocket over the upper poles of the sternum is created; hemostasis is achieved and the prosthesis is inserted.
- The wound is closed in layers according to the surgeon’s preference.
Perioperative Nursing Considerations
- Most implanted materials come sterile. However if they are not sterile, they should be washed first in a mild soap solution, dried carefully, and sterilized.
- To avoid dust particles settling on the implant before use, cover it with a paper drape sheet.
- Implants should be handled as little as possible and never with bare hands, since the oil from the handler’s skin could rub off onto the material.