Many patients are not candidates for autologous reconstruction such as DIEP flaps. Breast implants remain the most common form of breast reconstruction around the United States and around the world. Following mastectomy, patients often have a tissue expander placed as the first stage. Think of this as an empty breast implant that can have fluid added through an injection port after surgery to gradually expand the remaining skin left after mastectomy to allow for eventual secondary placement of an implant.
Occasionally, immediate breast reconstruction can be done with an implant instead of a first stage expander immediately following mastectomy in select patients, possibly saving the patients a second operation. This approach can sometimes be done in smaller breasted patients using a skin and nipple sparing approach.
Breast implants are not perfect and are associated with a host of problems including rupture and the need for replacement, capsule contracture which often leads to reoperation, chronic pain, and a more recent rare though serious issue called breast implant associated anaplastic large cell lymphoma (BIA-ALCL). Learn more about BIA-ALCL
Over the course of a patient’s life it is not uncommon to have several or more implant exchanges for a variety of reasons including implant rupture, capsule contracture, pain, and breast asymmetry.