Implant-Based Breast Reconstruction

Implant-based breast reconstruction is the most common way to rebuild your breast after you’ve had a mastectomy or lumpectomy. This type of reconstruction uses implants to restore the breast’s shape, size and symmetry. It can be done at the same time as surgery to treat breast cancer or later if you prefer.

Implant-based breast reconstruction uses a saline- or silicone-filled implant to reconstruct your breast. Implants come in different shapes and sizes to match your body type and give you the results you want. 

At Banner MD Anderson Cancer Center, our surgeons specialize in advanced implant techniques that help you get the best possible results while minimizing downtime and risks. They make sure your reconstruction fits your treatment plan and your goals.

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How implant-based reconstruction works

Implant-based breast reconstruction is usually done in either one or two stages:

• One-stage reconstruction: You have the permanent implant placed right away, at the same time as the mastectomy. One-stage reconstruction is also called direct-to-implant.  Direct-to-implant surgery is not available for all patients.  There are strict criteria that need to be met for this procedure.
• Two-stage reconstruction: You have a temporary tissue expander placed first, to stretch the skin (and sometimes muscle) where the breast was removed. Saline is added to the expander gradually, to create a pocket for the implant. Three months after the pocket is created, your surgical team replaces the expander with a permanent implant, usually in outpatient surgery with about a two-week recovery time.

Two-stage surgery lets doctors check the final test results from the breast removal and lymph node biopsy before doing the final breast reconstruction, if needed.

With implant reconstruction, surgery usually takes less time and you generally recover more quickly than with autologous (tissue flap) reconstruction, which uses your own tissue. 

Types of implants

You and your surgeon will choose the type of implant that best fits your body type and preferences:

• Silicone implants: These implants feel more like natural breast tissue and come pre-filled to a certain size.
• Saline implants: These implants are filled with sterile salt water during surgery and can be adjusted to a specific size.

Both silicone implants and saline implants are safe and FDA-approved. They come with either textured or smooth shells. Your surgeon will talk to you about which shape, texture and size may be best for you.

You may also have the option to combine an implant with your own tissue for extra softness or coverage. Learn more about hybrid reconstruction.

Benefits of implant reconstruction

Implant reconstruction can be an excellent choice because with it, you get:

• A shorter surgery and recovery time than using your own body’s tissues
• Surgery on only one part of your body
• Self-selected breast size and shape
• Smaller incisions and less scarring

If you choose breast implants, your surgeon will help you understand what to expect and how to care for your implants long term.

Risks and considerations

As with any surgery, implant reconstruction has some risks. You could face:

• Infection, fluid buildup or slow healing
• Scar tissue that tightens around the implant and causes an unnatural shape, called capsular contracture
• Implants that move or rupture
• Changes in breast sensation
• The need to replace the implant after 10 to 15 years

You may prefer a tissue flap reconstruction if you would like a breast that feels more like your own tissue. Implants can feel firmer, less mobile and colder (saline implants) than your own tissue.

You may also prefer a tissue flap reconstruction if you don’t want to take the time for the tissue-expansion process.

If you need radiation therapy, implants may not heal as well or may be more likely to shift position. Your surgeon will discuss whether a flap procedure may be better for you. 

Learn more about risks and complications and autologous reconstruction.

Implant reconstruction recovery and follow-up care

You will probably go home within a day or two after implant-based reconstruction surgery. Keep these points in mind:

• Expect mild tightness and swelling, which usually improves in a few weeks
• Move gently to support healing
• Avoid heavy lifting until your surgeon says it’s safe
• Attend regular follow-up visits to help monitor your healing and make sure the implants stay in the right position
• Expect full recovery to take four to six weeks

Find out more about what to expect during recovery and aftercare.

When implant reconstruction may not be ideal

Implant reconstruction is a popular option. But it might not be the best choice if you’ve had extensive radiation, you have significant scarring in the area or you don’t have much breast skin or tissue remaining after surgery to treat breast cancer.

In these cases, your surgeon may recommend autologous (tissue flap) reconstruction or hybrid reconstruction. These options may give you a more natural feel or better healing.

Why choose Banner MD Anderson Cancer Center

At Banner MD Anderson, you’ll receive care from plastic and reconstructive surgeons who specialize in breast cancer recovery. Our team of experts works together to coordinate every step of your care, from mastectomy to reconstruction and beyond. Our emphasis on safety, comfort and results means you can focus on healing. 

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