This type of breast reconstruction involves the restoration of the breast shape and volume using an artificial breast implant. Breast implants are specially shaped silicon bags that can contain either saline (salt water) or silicon gel. This type of procedure can be done in immediate and delayed reconstruction.

Are implants safe?
After many years of research, no link has been found with silicon implants and the development of cancer or other related health problems such as rheumatoid arthritis. In the rare event that an implant ruptures and leaks, the silicon should remain in the area around the implant. Leaks from saline implants can be absorbed safely by the body. Most surgeons would recommend that a ruptured implant is removed.

Is it like cosmetic breast surgery (breast augmentation)?
No. Breast augmentation is a cosmetic procedure which aims to enhance the existing breast shape. In breast reconstruction, almost all aspects of the shape have to be restored.

Immediate reconstruction using an implant
In immediate reconstruction the implant is inserted under the chest muscle (the pectoralis major), which is covered by the skin envelope left by the skin-sparing mastectomy. This can be done as a single-stage procedure with the use of tissue matrix. Alternatively, it can be done as a two-staged procedure using an tissue expander device first, which is used to create a pocket large enough to accommodate an artificial implant, which is inserted later.

Delayed reconstruction using an implant
In delayed reconstruction a tissue expander is initially placed under the mastectomy scar. It is gradually expanded with injections of sterile salt solution via a small valve at the edge of the new breast, near the armpit. After the skin and muscle have been stretched by the expander over the course of several months, the expander is removed and replaced with an implant which is slightly smaller than the tissue expander. The extra space created by the tissue expander means the final implant can lie against the chest wall, giving a more natural appearance.

The advantages

  • The surgery is less complex than Own Tissue Reconstruction and can be performed by any plastic or breast surgeon. It’s the most commonly used type of reconstruction.
  • In delayed reconstruction, the scar is usually in the same place as the original mastectomy scar.

And the disadvantages?

  • Although it is possible to insert implants in a single procedure, without using tissue expanders, this is usually only suitable for women who want smaller breasts.
  • The process of stretching the skin and muscle with tissue expanders is gradual and can take several months. Not all women will find this suitable.
  • It can be difficult to achieve a natural breast shape, even with the use of tissue expanders. The new breasts will always be firmer than natural breasts.
  • An implant will eventually need to be replaced (or may rupture). Further surgery will be required at some point in the future.

With Implant – More information

Operation time: Normally between 2 and 3 hours
Hospital Stay: Between 2 and 5 days
Type of Anaesthesia: General anaesthetic
Recovery Time: Around 3 Weeks
Risks of Surgery include: Bruising and swelling. Scarring.

Less commonly can include infection (5%); haematoma/seroma (swelling around a wound area where blood/body fluid has collected); lymphedema (when the lymph nodes are cleared); blood transfusion (unlikely); implant extrusion (when the body rejects the implant); capsular contracture (10%) (excessive or invasive scar tissue formation).

Further Treatment: Check up with your surgeon/registrar but in general regular visits to outpatients department for injections if tissue expanders are used and in some cases, a second operation is necessary to replace the tissue expanders with a permanent implant.
Nipple reconstruction: Around 3 months later
Nipple Tattooing: 1 month after reconstruction (by your surgical team)