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Breast reconstruction with synthetic implants was first introduced in the 1960s as a single-stage placement of a permanent implant at the time of mastectomy. This approach has evolved into a staged process, beginning with the placement of a tissue expander and gradual expansion over several weeks to months, followed by exchange with a permanent implant. Currently, this method is widely used for selected patients undergoing mastectomy because it is relatively straightforward and adds minimal operative time to the initial procedure.
Expanders may also be placed after resection, with later conversion to a permanent implant. This delay allows for planned radiation therapy without significantly affecting reconstructive outcomes. Optimal results require close collaboration among surgeons, medical oncologists, and radiation oncologists to individualize treatment and support safe, patient-centered care.
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Becker H, Mathew PJ. Immediate Prepectoral Breast Reconstruction in Suboptimal Patients Using an Air-filled Spacer. Plast Reconstr Surg Glob Open. 2019 Oct;7(10):e2470.
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Kalus R, Dixon Swartz J, Metzger SC. Optimizing Safety, Predictability, and Aesthetics in Direct to Implant Immediate Breast Reconstruction: Evolution of Surgical Technique. Ann Plast Surg. 2016 Jun;76 Suppl 4:S320-7.
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