Breast Cancer

Reconstruction with Implants

An implant is a silicone shell filled with saline (salt-water) solution or silicone gel. It is placed under the skin and muscle of the chest to create a breast mound. Silicone gel is under review by the United States Food and Drug Administration, but may be used for patients undergoing reconstruction following mastectomy.

Reconstructing a breast with an implant can take nine months to a year. Usually, the first step is to place a balloon-like device called a tissue expander under the skin and muscle of the chest. This is done at the time of the mastectomy. The expander slowly stretches the skin and chest muscle at the breast site to accommodate the implant. The patient then receives serial injections of saline, usually once a week, into the expander as an outpatient until the desired breast volume is achieved. This volume is greater than the reconstructed breast will be. The breast is left overexpanded for one to six months to help create a more natural appearance after implantation. After the expansion, the expander is reduced to the correct size to accommodate the implant. The expander is then removed and a permanent implant is placed. In general, an implant makes the breast firmer than a natural breast.