Most women who have mastectomy surgery to treat breast cancer go on to have one or both breasts reconstructed. There are many ways to reconstruct a breast. Tissue from the back, belly, or buttocks can be used to create a new breast. Saline or silicone gel implants are probably the most common choice.
A study found that women who chose a silicone gel implant were slightly happier with reconstruction after mastectomy compared to women who chose a saline implant.
Most experts consider silicone gel implants better than saline implants after mastectomy based on the look and feel of the implants. Still, most women choose saline implants. This is probably due to lingering concerns about the safety of silicone implants. These concerns first surfaced about 10 years ago.
There is a risk that any implant may rupture and leak. In the past, some women who had silicone implants that ruptured later developed inflammatory autoimmune diseases, such as arthritis and lupus. Many women believed the leaking silicone caused the autoimmune disease. Research suggests that silicone didn't cause the autoimmune diseases and most doctors believe that current silicone implants are safe. Still, many doctors recommend saline over silicone.
In this study 482 women who had implant reconstruction after mastectomy completed a survey (called the BREAST-Q Reconstruction Module) about reconstruction satisfaction. The women were treated in one of three U.S. medical centers or a Canadian medical center. Of the women who responded:
- 176 had a silicone implant and completed the survey about 2.4 years after reconstruction
- 306 had a saline implant and completed the survey about 3.3 years after reconstruction
Most of the women had reconstruction shortly after mastectomy (called immediate reconstruction).
The survey asked questions about breast shape and appearance, how the breast felt to touch, how normal the reconstructed breast made the women feel, and whether the women felt the breast was a part of them. Each answer got a score; the highest possible total satisfaction score was 100.
Average satisfaction scores were a little higher among women with a silicone implant:
- women with a silicone implant had an average satisfaction score of 58
- women with a saline implant had an average satisfaction score of 52.5
Satisfaction scores tended to decline over time. In other words, the more time that had passed since reconstruction, the lower the satisfaction score tended to be.
A small number of the women chose to have both breasts reconstructed (bilateral reconstruction). On average, these women were somewhat more satisfied with the reconstruction outcome (no matter which type of implant they chose) compared to women who had only the breast in which cancer was diagnosed reconstructed.
If you're having mastectomy to remove breast cancer and want to know more about reconstruction, it's important to talk to your surgeon about your options BEFORE the mastectomy is scheduled. You may want to have a breast reconstruction surgeon help you evaluate your options. The breast reconstruction surgeon may be a different person than the surgeon scheduled to perform the mastectomy.
You have many reconstruction choices, including the type of reconstruction and the timing of the reconstruction. The stage of the breast cancer affects the best time to do reconstruction. If you're considering implant reconstruction, you may want to ask your doctor about the pros and cons of both silicone and saline implants.
If you're having lumpectomy instead of mastectomy to treat breast cancer, it's still a good idea to talk to you doctor BEFORE the surgery about how your breasts will look afterward. You also may want to ask about the reconstruction options available if you're not satisfied with the way your breasts look after lumpectomy. Having the most complete information can help you feel better about yourself and your health after surgery.
Visit the Breastcancer.org Breast Reconstruction section to learn more about the different types of breast reconstruction.