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Implant-Based Reconstruction
The use of implants to recreate the shape of a breast after a mastectomy is a commonly employed reconstruction technique. Breast implants are typically filled either with saline or silicone, and come in a large range of shapes and sizes. This enables the surgeon to easily match the size and shape of the reconstructed breast to that of the healthy breast.
 
Fat-grafting is the process of taking fat from one part of the body, and placing it into another part of the body. It can be performed together with implant-based reconstruction to help increase the natural look of the reconstructed breast.
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As implant sizes in Australia do not exceed 800cc, the use of implants may not be appropriate for certain larger breasted patients undergoing mastectomies. For those patients, alternatives which make use of the patient's own tissue (autologous reconstruction) may be more appropriate. These alternatives include the latissimus dorsi flap, and the DIEP (deep inferior epigastric perforator) flap.
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Breast implants come in multiple sizes, shapes and textures. The surgeon will select one based on suitability and the patient's preferences
An illustration of a breast implant being inserted after a skin-sparing mastectomy of the right breast. A nipple may be reconstructed using the skin in the area, or a nipple tattoo may be applied
The use of implants for reconstruction presents a set of advantages and disadvantages compared to other forms of reconstruction that make use of the patient's own tissue.
Advantages:
  1. In general, the recovery time for implant-based reconstruction is shorter
  2. The availability of many shapes and sizes of implants make it easier to match the appearance of the reconstructed breast to that of the other breast
  3. Can usually be performed without needing additional incisions, thus additional scarring is avoided
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Disadvantages:
  1. Breast implants do not respond well to radiotherapy. If a mastectomy patient is required to undergo radiotherapy, then a temporary implant (called a tissue expander) may be inserted first. After radiotherapy is completed, the tissue expander can be switched out to a permanent implant
  2. The shape of a woman's breast typically changes as the woman ages, or if she gains/loses weight. An implant remains constant in size and shape. Therefore, a patient with one implant may notice that asymmetry (imbalance) may become more noticeable between the breasts as she ages, or her weight changes
  3. Other risks that may be associated with breast implants, including capsular contracture and implant rupture
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