Implant Based Breast Reconstruction

What is Implant-Based Reconstruction?

Implant-based reconstruction uses a breast implant — a silicone prosthesis — to recreate the volume and shape of the breast. It is the most commonly performed type of breast reconstruction and is a well-established, effective technique for suitable candidates.

How Does it Work?

Implant-based reconstruction can be performed in one or two stages.

In a one-stage (direct-to-implant) reconstruction, the final implant is placed at the time of mastectomy. This approach is most suitable when there is sufficient, good-quality skin and soft tissue to support the implant immediately.

In a two-stage reconstruction, a tissue expander — a temporary, adjustable implant — is placed at the time of mastectomy and gradually inflated over a period of weeks to months in the rooms. This stretches the overlying skin and soft tissue to create the necessary space and pocket for the final implant, which is then inserted in a second, shorter operation.

In both approaches, a biological or synthetic mesh — known as an acellular dermal matrix (ADM) — is often used to support the lower portion of the implant and help shape the reconstructed breast. 

Is Implant-Based Reconstruction Right for Me?

Implant-based reconstruction tends to be most suitable for women with smaller to medium-sized breasts, those who prefer a shorter and less complex initial operation, and those who wish to avoid scars at a donor site elsewhere on the body.

It is generally less suitable for women who require post-mastectomy radiotherapy, as radiation significantly increases the risk of complications with implants — including capsular contracture, implant firmness, and implant failure. In these situations, autologous reconstruction is often a more resilient long-term option, and your surgeon will discuss this carefully with you.

Long-Term Considerations

Breast implants are not lifetime devices. While modern implants are durable and the large majority of women have no significant problems, it is important to understand that implants may need to be replaced or removed at some point in the future. Your surgeon will discuss what long-term follow-up and monitoring involves.