Out of all the reconstruction techniques, using an implant to rebuild the breast requires the least amount of surgery. The implant can be filled with:
- saline (salt water)
- silicone gel
- a combination of the two -- silicone or vegetable oil in the outside chamber and saline on the inside
The implant is placed under the pectoral chest muscle. Implant reconstruction involves less surgery than reconstruction using tissue from another place on your body, so the length of the surgery and your time of recovery are usually shorter.
Implants usually don't last a lifetime, so you'll probably need more surgery to replace an implant at some point. The American Society for Aesthetic Plastic Surgery and the American Society of Plastic Surgeons say that both saline and silicone implants last between 10 and 20 years.
Implants are a good option for thin women with small breasts because these women often don't have enough extra tissue on their bellies, backs, thighs, or buttocks to form a good breast shape.
Implants come in teardrop or round shapes. One of these shapes may be a better match for the contour of your breast area. The surface of the implant may be smooth or have a slightly rough texture -- but you won’t feel this through your skin. Your plastic surgeon may prefer one type of implant over another for technical reasons. In some cases, implants with a slightly rough texture may help lower the risk of scar tissue forming around the implant.
You may have implant reconstruction at the same time as mastectomy (immediate reconstruction), after mastectomy and other treatments (delayed reconstruction), or you might have the two-step approach that involves some reconstructive surgery being done at the same time as mastectomy and some being done after (delayed-immediate reconstruction).
Saline vs. silicone
Saline implants are the most common implant used. While the shell is made of silicone, the implant is filled with a salt water solution known as saline. Saline implants tend to feel firmer than silicone implants.
Saline implants have been more popular because of concerns that silicone implants might leak and cause immune system diseases. But research has shown that silicone implants don't increase the risk of immune system disorders; the U.S. Food and Drug Administration approved the use of silicone gel-filled breast implants for breast reconstruction in 2006.
Silicone gel implants are filled with liquid or firm silicone gel. They tend to feel softer than saline implants and some women think the texture is more like natural breast tissue.
All implants have a slight risk of rupturing. If a saline implant ruptures, the saline leaks out quickly and the breast appears somewhat deflated, so you know immediately that it's ruptured. The salt water is absorbed by the body. If a silicone implant ruptures, the gel leaks out more slowly because it's thicker, so it may take you longer to realize that the implant has ruptured. Silicone gel is not absorbed into the body; the gel can sometimes leak into the pocket surrounding the implant and stay there, or it may spread further. In either case, surgery would be required to replace the implant.
If you’re concerned about the safety of silicone in your particular situation, saline-filled implants can be a more reassuring alternative.
Talk to your surgeon about which type of implant is best for you. Ask if you can handle a sample implant of each material so you can decide if you prefer one texture over the other.
Researchers are studying alternative breast implants that are filled with different materials, but these types of implants are available only if you're a participant in a clinical trial. Talk to your surgeon if you're interested in being a participant in an alternative implant trial.
In this section, you can learn more about what to expect with implant reconstruction, including the risks: