Breast implants
Breast implants are medical devices utilized primarily for reconstructing the appearance of one or both breasts after a mastectomy due to breast cancer. They can be made from the patient's own tissue, known as autologous implants, or from artificial materials, specifically saline or silicone. Saline implants have a silicone shell and are filled with saline solution, while silicone implants contain silicone gel, which often provides a more natural look and feel. Both types of implants have been approved for use in the United States, with saline implants receiving FDA approval in 2000 and silicone implants in 2006.
The decision to use breast implants typically occurs during a surgical procedure following mastectomy, and various factors such as the patient's health, aesthetic goals, and any prior treatments like radiation can influence the timing and method of reconstruction. While breast implants can provide enhanced aesthetics and symmetry, they carry risks such as rupture, leakage, and infection. Autologous implants, derived from the patient's own body tissue, eliminate the risk of rupture and do not require replacement but involve a more complex surgical process.
Post-surgery recovery varies, with most patients resuming normal activities within six to eight weeks. Breast implants do not usually interfere with breastfeeding, though specialized mammography procedures may be necessary. The ultimate goal of breast reconstruction with implants is to achieve a symmetrical, natural-appearing breast shape.
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Breast implants
ALSO KNOWN AS: Autologous breast implants, saline breast implants, saline-filled breast implants, silicone breast implants, silicone-filled breast implants
DEFINITION: Breast implants are used to reconstruct the natural appearance of one or both breasts following mastectomy for breast cancer. Breast implants may be composed of the patient’s own tissue taken from elsewhere on the body (autologous breast implants) or made of artificial substances (saline or silicone breast implants).
Cancers treated:Breast cancer
Why performed:Breast reconstruction is an option for women following mastectomy. Mastectomy involves surgically removing one or both breasts for the treatment of breast cancer. Breast implants are used to replace breasts that have been removed, to create a symmetrical appearance if only one breast was removed, or to replace the one breast that was removed and enhance the appearance of the remaining breast to improve symmetry. Breast implants are an alternative to wearing breast prosthetics (removable breast forms).
Patient preparation: Breast implants come in a variety of shapes, sizes, and compositions. The plastic surgeon guides the patient in the selection process. Tissue expanders may or may not be used to stretch the skin in preparation for breast implant placement. In some cases, the tissue expander may be filled with saline and remain in the body, serving as the breast implant.
There are two basic types of artificial implants, saline breast implants and silicone breast implants. Saline breast implants have a silicone outer shell and are filled with saline, a saltwater solution. Saline implants may be prefilled by the manufacturer or filled at the time of surgery and adjusted after surgery.
Silicone breast implants have a silicone outer shell and are filled with silicone, a natural substance. Silicone breast implants may be prefilled with silicone by the manufacturer and nonadjustable, prefilled with silicone and allow for saline insertion at the time of surgery, or prefilled with silicone and allow for saline insertion at the time of surgery and postsurgical adjustments.
Saline implants were approved for use in the United States by the Food and Drug Administration (FDA) in 2000. Silicone implants were approved by the FDA in 2006. Both types of implants are not meant to last a lifetime, may need to be replaced, and have a risk of rupture. Saline implants are advantageous in that ruptures are readily identified because the breast size decreases and the saline solution is absorbed by the body. The size of saline implants can be adjusted easily. Some people believe, however, that saline implants do not look or feel as natural as silicone implants.
Silicone implants have a texture similar to natural breast tissue. While silicone breast implants may look and feel more natural than saline implants, ruptures may not be as easily noticed with silicone breast implants. Following a rupture, the silicone remains near the implant and is not absorbed by the body.
Autologous implants are made of tissue or a tissue flap that is taken from the patient, commonly the abdomen and buttocks. The tissue may contain fat, muscles, blood vessels, and nerves. Autologous implants are a more specialized procedure involving microsurgery and take longer to heal, but they do not have the risk of rupture and do not need to be replaced over time. Some people believe that autologous implants produce the most natural results.
Steps of the procedure: Breast implants may be inserted at the time of the mastectomy or at a later time in another surgery. Patients receiving radiation therapy following mastectomy may need to delay breast reconstruction. Breast implant procedures do not delay chemotherapy. Breast reconstruction surgery is performed with general anesthesia. Nipple reconstruction may take place following a breast implant procedure.
After the procedure: Patients may spend one to six days in the hospital, depending on the procedure. Patients wear bandages and support garments while healing. Activities may be temporarily restricted, but most activities can be resumed in six to eight weeks.
Artificial implants typically need to be replaced in time. Breast implants should not affect breastfeeding. Special mammography procedures may be needed, however. Breast implants only rarely obscure the detection of new cancer formation.
Risks: The risks of artificial breast implants include rupture, leakage, rippling, infection, and capsular contraction (in which scar tissue surrounding the implants shrinks or hardens). Textured implants, both silicone and saline, have been linked to cases of anaplastic large cell lymphoma (BIA-ALCL). Other risks include the general risks associated with surgery and anesthesia.
Results: The optimal result is symmetrical, natural-appearing breasts.
Bibliography
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Peters, W. J., et al. Biomaterials in Plastic Surgery: Breast Implants. Philadelphia: Woodhead, 2012. Print.
Poeppl, N., et al. “Does the Surface Structure of Implants Have an Impact on the Formation of a Capsular Contracture?” Aesthetic Plastic Surgery 31.2 (2007): 133–39. Print.
“New Breast Reconstruction Advances.” Johns Hopkins Medicine, www.hopkinsmedicine.org/health/wellness-and-prevention/new-breast-reconstruction-advances. Accessed 5 July 2024.
“Silicone Gel-Filled Breast Implants Approved.” FDA Consumer 41.1 (2007). Print.
Spear, Scott L., et al. Surgery of the Breast: Principles and Art. 3rd ed. Philadelphia: Kluwer/Lippincott, 2011. Print.
Stevens, W. G., et al. “A Comparison of Five Hundred Prefilled Textured Saline Breast Implants Versus Five Hundred Standard Textured Saline Breast Implants: Is There a Difference in Deflation Rates?” Plastic and Reconstruction Surgery 117.7 (2006): 2175–81. Print.
Vázquez, G., and A. Pellón. “Polyurethane-Coated Silicone Gel Breast Implants Used for Eighteen Years.” Aesthetic Plastic Surgery 31.4 (2007): 330–36. Print.