Breast Implant Choices

Surgical Considerations to Discuss with Your Doctors

Discuss the advantages and disadvantages of the following options with your surgeon and your oncologist:

• Immediate Reconstruction
  Single-stage immediate reconstruction with a breast implant or an expander/mammary implant. (see adjustable tissue expander/breast implants)
  
  Two-stage immediate reconstruction with a tissue expander, followed by delayed reconstruction several months later with a breast implant.
  
  
• Delayed Reconstruction
  Single-stage delayed reconstruction with a breast implant (or an expander/mammary implant. (see adjustable tissue expander/breast implants)
  
  Two-stage delayed reconstruction with a tissue expander, followed several months later by replacement with a breast implant
  
  
• Flap procedure with or without a breast implant

Two potential advantages to immediate reconstruction are that your breast reconstruction starts at the time of your mastectomy and that there may be cost savings in combining the mastectomy procedure with the first stage of the reconstruction. However, your initial operative time and recuperative time may be longer.

A potential advantage to delayed reconstruction is that you can delay your reconstruction decision and surgery until other treatments, such as radiation therapy and chemotherapy, are completed. Delayed reconstruction may be advisable if your surgeon anticipates healing problems with your mastectomy, or if you just need more time to consider your options.

There are medical, financial, and emotional considerations to choosing immediate versus delayed reconstruction. You should discuss with your surgeon, plastic surgeon, and oncologist the pros and cons of the options available in your individual case.

Breast Reconstruction with Expander/Implants

Breast Reconstruction without Implants: Tissue Flap Procedures

Implant Size

Your surgeon will evaluate your existing chest tissue to determine if you have enough tissue to accommodate the desired size of breast implant.

If you desire a breast implant that is too large for your tissue, the breast implant's edges may be visible through your skin after your operation or the implant may be more easily felt. By choosing an implant that is too large for your tissue, you may increase the risk of having surgical complications. Also, breast implants that are excessive in size may increase the effects of gravity on your body, which may cause your breasts to prematurely droop or sag.

Adjustable Breast Implants

Mentor's Spectrum™ breast implant and Becker Expander/Mammary implant help eliminate the problem of choosing the exact size implant you want before your surgery. The Spectrum implant is a saline-filled breast implant with a removable fill-tube that lets your physician adjust the size of your breasts after your surgery. In a simple office procedure, your physician can change your implant size by either adding or removing saline for up to six months after your surgery. These implants may eliminate the need for a second-stage surgical procedure.

Implant Shape

Mentor breast implants come in either round or contoured shapes. When contoured implants are placed under the chest muscle they may assume a round shape after implantation. Together you and your physician will select the option that is best for you, and most likely to achieve the result you desire.

Implant Surfaces

Breast implant shells have a smooth or textured surface. As a natural reaction to any device placed in the body, scar tissue will form around the breast implant surface creating a capsule. In some women, the capsule can tighten and squeeze the implant. This occurrence is called capsular contracture. Textured-surface implants were designed to reduce the chance of capsular contracture.

Some information in the literature on small numbers of patients suggests that surface texturing reduces the chance of severe capsular contracture, but clinical information from studies of a large number of women with Mentor implants shows no difference in the likelihood of developing capsular contracture with textured implants compared to smooth-surfaced implants.

Choosing the implant surface that is right for you should be discussed with your physician.

Implant Materials

Breast implants are made with silicone elastomer (rubber). The silicone elastomer (rubber) contains the following substances: (1) small amounts (parts per million) of various smaller silicones; 2) small amounts (50 - 100 parts per million) of metals like tin and platinum and very trace amounts of other metals; 3) trace amounts of volatile materials like xylene and other organic compounds; and 4) considerable amounts (approximately 20 parts per hundred) of finely powdered silica that is tightly bound to the silicone rubber pouch.