Breast implants are a way to recreate the
shape of a breast after part or all of the breast is removed (mastectomy) because of cancer.
A breast implant
is a soft silicone shell filled with saline (salt water) or silicone gel.
Silicone may create a more natural-looking breast, because its weight and
texture is more like breast tissue. But saline is used most often, because it
can be safely absorbed by the body if the implant leaks.
Breast reconstruction usually takes more
than one surgery. Sometimes an implant is placed during the same surgery as
mastectomy. The nipple and the brown area around it (areola) are created at a
later time. But often the doctor will first place a balloon (tissue expander)
beneath the chest muscle. Saline is added to the balloon every 1 to 2 weeks to
help stretch the skin and muscle. This may take several months. When the right
size is reached, the balloon is taken out and an implant is put in.
See a picture of a
breast implant and tissue expander.
Implant surgery is done by a
plastic surgeon. The breast surgeon who does your
mastectomy can refer you to a plastic surgeon with special training in breast
You will meet with the plastic surgeon before your
mastectomy to discuss the best procedure for you. The surgeon can show you
pictures of other women who had implants after mastectomy. Ask to see both the
best and worst results so you can get a better idea of what can happen. You can
also ask to talk to women who have had the surgery.
Before having this surgery or any other surgery, you may want to see another surgeon to get a second opinion.
Breast implant surgery is usually done
general anesthesia, so you sleep during the procedure.
When you wake up from surgery, you will have bandages over the surgery sites,
and you may wear a special bra that holds your bandages in place. You may have
drainage tubes to collect fluid and keep it from building up around the surgery
If the implant was placed at the same time as your
mastectomy, you may stay in the hospital for 2 or 3 days. If the implant is
placed later, you will probably be able to go home the same day.
Most women have soreness, redness, and swelling in the breast after
implant surgery. You may need pain medicine for a week or two. Your doctor will give you instructions on how to care for your incision. Your doctor may
antibiotics to help prevent infection.
You may be able to go back to work or your normal routine in 3 to 6 weeks
or sooner. Most women need to avoid strenuous activity for several weeks.
Breast implant surgery can be done to
restore the appearance of a breast after mastectomy. It may also be done for
women who have problems with breast development.
reconstruction may help a woman feel better about her appearance. Some women
say it helps them feel better about their bodies, more alive,
feminine, and sexual—and happier about life.
Breast implants work best for women
who have small breasts (A or B cup) or for women who have both breasts removed
Compared to tissue flap surgery for breast
reconstruction, breast implant requires a shorter surgery and has a quicker
A breast implant may not last the rest of your
life. You may need to have later surgery to replace the implant.
Many of the risks associated with breast
reconstruction are the same as those with any surgery: infection, poor wound
healing, bleeding, or a reaction to the anesthesia used in surgery.
Other risks from breast implants include:
Some women are at higher risk for problems from surgery.
This includes women who:
It is important to know that your
breasts will look different after surgery. Your new breast may feel firmer and
look rounder or flatter than your other breast. Some women have surgery on the
other breast to make them look as much alike as possible. Other women find that
wearing a bra hides the differences.
The incisions will leave
scars on your breasts. These will fade with time. The surgeon will try to make
incisions that leave as few scars as possible.
Some women choose
to get a breast implant first and have tissue flap surgery later, when they
feel stronger or have more time. For more information about this type of
2006, the U.S. Food and Drug Administration lifted restrictions on the sale of
silicone breast implants for both reconstructive and cosmetic surgery. Studies
done between 1992 and 2006 did not find evidence of a link between silicone
implants and connective tissue diseases or cancer. At this time,
silicone breast implants have no known risks of cancer or other
requires insurance companies that cover mastectomy for breast cancer to also
cover breast reconstruction. Check with your insurance company to find out what
your costs will be. If you are considering a silicone implant, you will want to
find out if your insurance will pay for the cost of follow-up MRIs.
Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.
Cordeiro PG (2008). Breast reconstruction
after surgery for breast cancer. New England Journal of Medicine, 359(15): 1590–1601.
June 28, 2011
Sarah Marshall, MD - Family Medicine
& Douglas A. Stewart, MD - Medical Oncology
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