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Breast Reconstruction

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Dr. Becker is recognized both nationally and internationally as an expert in breast reconstructive surgery. He has lectured and published extensively on the subject.

Dr. Becker is best known as the inventor of the adjustable breast implant, otherwise known as the Becker Expander Mammary prosthesis. The Becker Expander implant functions as a tissue expander, and then converts to a breast implant once the tissues have been expanded sufficiently.

Traditionally, a tissue expander is placed at the first surgery and used to expand the overlying skin. It is then removed at a second surgery and replaced with a breast implant. Thanks to the invention of the Becker Expander implant, a second operation is no longer necessary to replace the expander with an implant- it can all be done in one surgery.

The Becker Expander implant has become one of the most widely used implants for breast reconstruction. It is used in many countries throughout the world.

The results of reconstruction following mastectomy are directly related to the mastectomy technique that is performed. The techniques used for mastectomy are dependent on the nature of the condition being treated and the philosophy of the treating surgeon.

Reconstructive Options for a Patient Diagnosed with Breast Cancer

The reconstructive options are directly related to the surgery recommended by the surgeon to deal with the breast cancer. The surgical options include:

  1. Lumpectomy and Radiation
  2. Mastectomy:
    • Radical mastectomy
    • Modified radical mastectomy
    • Skin-sparing mastectomy
    • Nipple-sparing mastectomy

The reconstructive options will also depend on the individual patient’s’ health, breast size, shape, and weight.

Lumpectomy and Radiation

  1. No further treatment may be necessary
  2. Fat injections can be used to fill in the deformity
  3. Rotation of surrounding tissue can be used to fill in the defect (Oncoplastic repair)

Breast reduction is typically performed as part of the lumpectomy.


Radical mastectomy hardly ever is performed today. Reconstruction requires flap repair. Modified radical mastectomy and nipple sparing mastectomy are more common, and can involve:

  • Direct to implant reconstruction at the time of mastectomy
  • Tissue expander placement at the time of mastectomy with second stage placement of silicone gel implant
  • Adjustable breast implant placement at the time of mastectomy
  • Flap reconstruction

Any of the above techniques may be performed, including fat injection with external expansion. Examples of the above techniques are available on this web site






Click here to read Dr. Beckers article on Vertical Mastectomy Incision With One Stage Immediate Pre-Pectoral Reconstruction

Click here to read Dr. Becker’s article on Immediate Implant-based Prepectoral Breast Reconstruction Using a Vertical Incision

Dr Beckers current technique for immediate breast reconstruction performed at the time of the mastectomy

Due to the fact that surgeons are now more frequently performing skin sparing and even nipple sparing mastectomies, it is more feasible to place the expander above the muscle.
Placement above the muscle has several advantages:

  • Elimination of animation deformities (abnormal implant movement as a result of muscle contraction)
  • Shorter surgery time , less post operative pain
  • New tissue planes are not opened

In cases where additional protection is needed for the incision, eg. if there is excess tension on the incision or poor blood supply such as with thin skin flaps, The expander is placed below the muscle. Where the implant has been placed below the muscle, the implant can still be placed above the muscle at the second procedure when the expander is replaced with the silicone gel implant

Dr. Becker discusses Breast Reconstruction with Adjustable Implants

Breast Cancer and Diet

Prophylactic Mastectomy with Immediate Reconstruction

For women diagnosed with breast cancer, or advised by their surgeon to undergo a prophylactic mastectomy, revolutionary new procedures have become available that enable a patient to undergo a mastectomy with the possibility of preserving all the breast skin, the areola and even the nipple.

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Prophylactic preventative mastectomy is the surgical procedure performed to remove one or both breasts in an effort to prevent or reduce the risk of developing breast cancer.

There are several options available to patients undergoing prophylactic mastectomy and reconstruction.

One of the techniques that many patients do not know about is that of nipple-sparing mastectomy: one stage reconstruction using an adjustable implant placed above the muscle.
The advantage of this technique is that it avoids the problems related to implant placement under the muscle such as abnormal breast movement when the muscle contracts and high riding implants due to the muscle tending to elevate the implant.

The adjustable implant enables the reconstruction to be done at the time of mastectomy.

Dr. Becker is a pioneer in this procedure, having been the developer of the Becker adjustable gel implant and the Spectrum adjustable saline implant.

While a flap can be used to replace the volume of the breast, the implant developed by Dr. Becker (the Mentor Becker 50/50) is considered by many surgeons to be the ideal implant to reconstruct the breast following prophylactic mastectomy.

The adjustable implant is placed above the muscle. The injection port which attaches to the implant is placed beneath the skin.
Once healing is assured (usually 1-2 days) filling of the implant is done by injecting saline into the port. Filling is usually completed in several days. The injection port is removed under local anesthesia once the patient is satisfied with the results.

As the implants are placed above the muscle, there is less pain and no abnormal distortion of the implant by the muscle. Saline is added once the skin has sufficiently healed, and then over-expanded to improve the shape of the breast. The volume is then reduced, and the injection dome is removed through a tiny incision. In select cases where circulation to the skin is not comprised, a gel implant can be used to eliminate the need for delayed filling or expansion.

Dr. Becker, an internationally known plastic surgeon, is the inventor of the adjustable breast implant and has published over 30 articles and contributed chapters to plastic surgery textbooks. He serves as an instructor at national plastic surgery meetings, lectures internationally, and holds regular workshops around the world demonstrating his sought-after surgical techniques

Dr. Becker, an internationally known plastic surgeon has pioneered this procedure. He is the inventor of the adjustable breast implant and has published over 30 articles and contributed chapters to plastic surgery text books. He serves as an instructor at national plastic surgery meetings, lectures internationally, and holds regular workshops around the world demonstrating his sought-after surgical techniques


Patient with carcinoma of right breast


Following bilateral nipple sparing mastectomy
with adjustable implants placed above the muscle
and absorbable mesh support


Final result


No abnormal implant movement

Becker Adjustable Implant

For more information on the Becker adjustable implants, Click here.


    • Volume can be changed after surgery
    • Patient has input into final size
    • Better able to correct asymmetry
    • Better able to treat complications following previous breast surgery i.e., irregularities in shape, capsular contracture, symmastia (disruption of midline)

Now you can change the size of your breasts without additional surgery.

Implant with no saline added.


Saline added to implant via injection port.


Injection port removed once final volume is achieved


The adjustable breast implant, which was developed in 1985 by Dr. Becker, is used in this procedure. The implant consists of a silicone membrane that is filled with saline via detachable dome. Saline (salt water solution) is added or removed from the implant post-operatively by inserting a thin needle through the skin into the injection dome. Once the patient is satisfied with the size and shape of her breasts, the dome is removed usually three to six months post-operatively. The implant seals at the self-sealing valve. Alternatively, the injection dome may be exteriorizied and removed one week later.

Implant placed at time of surgery.

Saline added to implant.

Saline removed from implant.

Injection port removal through small incision.

Injection port removed.

If the patient wishes to enlarge (or decrease) the size of her breasts after surgery, a needle is placed through the skin into the injection dome. Saline solution is then injected (or removed) to adjust to the size (and shape) of the breast. When the patient is satisfied with the result, the injection dome can be removed under local anesthetic.

It is the ability of the adjustable breast implant to correct or improve difficult breast problems such as ptosis, tubular and unilateral breast development that makes this implant so unique. The adjustable-fill breast implant is useful in expanding underlying tissue and generating more breast tissue to create a more natural and symmetrical breast shape. Because these implants can be filled gradually over a period of several months, discomfort is minimized while the skin slowly stretches. In order to avoid the unnatural, hard-looking appearance of some augmentations, especially the upper fullness. Adjustable breast implants can be overfilled, then the volume reduced, allowing the breast to relax, producing a more natural appearance.

For more information on the Becker adjustable implants, Click here.

Breast reconstruction with fat grafting

Thanks to recent advances in tissue transfer, it is now possible to reconstruct the breast following mastectomy using the patient’s own fat. This is done without implants or complex surgical procedures. Dr. Becker is a pioneer in fat harvesting techniques having developed several instruments currently used in this procedure. He has now combined techniques developed in the United States and Europe to offer the patient breast reconstruction using their own fat. Fat is harvested during a liposuction procedure.

The procedure is often enhanced with external expansion known as the BRAVA®. This is an external expansion device that stretches the skin before the fat is injected. Recovery is more rapid and there is less down time. The breasts feel natural and sensation often returns. An added benefit is the body contouring as a result of the liposuction.

Fat grafting can be done:

  1. At the time of the mastectomy and continued after surgery
  2. As a delayed procedure after the mastectomy
  3. To correct complications following previous surgery
  4. Following lumpectomy and radiation defects

Fat tissue contains fat derived stem cells. These cells stimulate healing, increase the circulation and have a rejuvenating effect on the tissues. Fat grafting therefore is also used for facial rejuvenation and correction of scarring such as burns wounds and radiation.

Dr. Becker’s response to questions on

Click here for Dr. Becker’s response to questions on

Dr. Becker believes that single-stage breast reconstruction affords his patients several important benefits. “The advent of single-stage reconstruction enhances the physical and emotional well-being of my patients because it allows them to awake after their mastectomy with some breast fullness that will be expanded to their satisfaction.”

Technical Information Breast Reconstruction: Complication Rate and Tissue Expander

Many patients look as good, if not better, after their bilateral mastectomy and reconstruction then they did before the surgery. For more information about options in breast reconstruction, please call (800) MENTOR-8.

It is important to note that every woman’s body and medical condition is different; so not all women are eligible for single-stage reconstruction. Your doctor is the best person to discuss with you whether or not single-stage breast reconstruction is a suitable option.

Dr. Becker has published numerous articles on this procedure. He lectures nationally and internationally and has been featured on 20/20, Healthcare network, MSNBC Special Edition and Extra. He was listed in Good Housekeeping as one of America‘s Top 184 Breast Cancer Reconstructive Surgeons.