Immediate breast reconstruction after mastectomy using a permanent tissue expander.

We describe a new breast implant that greatly facilitates immediate breast reconstruction after mastectomy. Through a detachable filling reservoir, the implant can be filled with saline by percutaneous injection; this allows the empty implant to be placed in position and filled only after viability of the flaps is assured. Because filling can be controlled, the fear of skin flap necrosis or wound breakdown is eliminated. Furthermore, the chest wall skin can be expanded, thus avoiding the use of distant flaps.