In hybrid reconstruction, a silicone or saline (salt water) breast implant is placed above the muscle (preprectoral) and then covered with a layer of your own body fat, taken from a donor site such as the abdomen, thigh, or buttock.
Combining natural tissue with an implant allows for the creation of a bigger breast than might be possible using only your own tissue from a single donor site, especially if you’re thin or don’t have a lot of body fat. The implant is covered with natural, living fat, which makes the breast feel warmer and more natural than a breast recreated through implant reconstruction. Acellular dermal matrix (ADM), a “sling” made of collagen, is typically used in hybrid breast reconstruction to hold the implant in place.
Hybrid reconstruction is usually started at the time of mastectomy. Often the entire procedure, which involves placing an implant and collecting a flap of tissue from a donor site on your body (abdomen, thigh, buttock, etc.) can be completed during the mastectomy.
Some patients, however, may need to have delayed (two-stage) reconstruction. Like implant-only reconstruction, a tissue expander is inserted under the breast skin during the mastectomy. The tissue expander is like a balloon that contains a port or plug. Over a period of months, the tissue expander is gradually enlarged with saline that’s injected into the port. This stretches the surrounding muscle and skin until there’s enough space for the permanent implant. The tissue expander can then be removed and replaced by the permanent implant in an outpatient procedure. Hybrid breast reconstruction can also be performed many years after mastectomy.