Restoring form and volume to a breast using an implant requires the insertion of a prosthesis made of synthetic material into the mastectomy site. Implants come in a variety of shapes and sizes, and are filled with either saline or silicone gel.
Compared with natural-tissue breast reconstruction, there are some advantages to implant breast reconstruction. Of all methods of reconstruction, implant-based reconstruction typically requires the shortest period of hospitalization. Because there is no “donor site” from which tissue is borrowed, there is no additional scar elsewhere on the body and no need to heal at a second surgical site.
Nevertheless, the advantages of this quicker and technically less demanding reconstructive method must be weighed against the disadvantages of later complications that can lead to unplanned re-operation and implant removal. Data show that approximately 40% of women will require unplanned re-operation within just 5 years of their initial surgery. According to information published by a one of the major manufacturers of breast implants, “Breast implants are not considered lifetime devices. You will likely undergo implant removal with or without replacement over the course of your life.”
In addition to complications that can lead to unplanned re-operation, in late January 2011, the Food and Drug Administration raised concerns about a possible link between breast implants and a rare form of lymphoma called Anaplastic Large Cell Lymphoma or ALCL. The FDA is actively investigating this possible link, however, preliminary data suggest that women who have breast implants have been developing ALCL much more frequently than women who do not have breast implants. At present, the FDA advises the following:
Methods that use natural tissue can create reconstructed breasts that are a woman’s for life and also typically have the most natural look and feel. Our practice specializes in the most sophisticated natural-tissue reconstruction procedures that are appealing alternatives to implant reconstruction for many women. Nevertheless, such methods may not suit every woman who is considering breast reconstruction.