Two different types of prosthesis are used for implant reconstruction of the breast:

• Temporarily implanted tissue expanders
• Permanent fixed volume breast implants

Tissue expanders are used to give elasticity to the breast skin before the placement of a permanent prosthesis. They are temporarily inflated by injecting increasing amounts of salt water into the reservoir inside. When the time comes, it is removed and replaced with a permanent implant or it is possible to leave some special types of tissue expanders in place like a permanent implant.

Fixed volume permanent implants are usually silicone-based products. Silicone prostheses with a gel-filled, rough surface are usually used.

The use of only synthetic implants for reconstruction is preferred by patients who do not want surgery on their back or abdomen.

Reconstruction with synthetic implants is not a good option in patients who have received radiotherapy to the chest wall or who are likely to undergo postoperative radiotherapy.

In reconstruction procedures with either a tissue expander or a permanent implant, the prosthesis is placed under the muscles of the anterior chest wall.

Who is Suitable for Silicone Breast Implants?

• If the patient’s own body tissue suitable for breast reconstruction is not available,
• If the breast tissue area is not badly scarred or infected,
• If prophylactic (preventive) mastectomy has been performed,
• If bilateral breast reconstruction is performed,
• If the patient has consented to other breast surgery to achieve symmetry,
• If she has not received radiotherapy to the breast or chest wall; she is an ideal candidate for breast reconstruction with silicone breast prosthesis.

Reconstruction with Breast Implant in One Session

The cancerous breast is removed, preserving the breast skin and, if possible, the nipple. In the same session, a breast implant is placed under the pectoral muscle. This method is generally preferred in patients with early-stage cancer and those with small, healthy breasts. Sometimes people who carry the breast cancer gene may also prefer this procedure by having their breasts removed before cancer develops.

Reconstruction with Breast Implant in Two Sessions

In cases where the breast tissue is removed together with the skin, the remaining skin may not provide enough space to place the implant. In this case, a half gel, half hollow prosthesis is placed in the area. This prosthesis is slowly inflated with saline over 2 to 3 months. The temporary prosthesis is removed when the skin in this area is judged to provide enough abundance. It is replaced with a permanent gel implant. Sometimes, with a temporary implant, time can be saved for additional treatments such as radiotherapy.