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Breast implants, both saline and silicone, have been used for breast reconstruction surgery for more than thirty years. At first, implants were the only option to rebuild a woman's breast after mastectomy, but that changed in the late 1970's with the introduction of the TRAM flap.
While surgical techniques for placing an implant have evolved, and the outer shell and inner filling of an implant have changed over the years, the problems associated with breast implant reconstruction in a patient who has undergone a mastectomy remain the same.
This patient underwent mastectomy and implant reconstruction by another doctor. There was capsular contracture and displacement of the implant which left her with the result on the left. The implant was removed and she underwent DIEP flap reconstruction with lifting of the other breast to obtain the final result on the right.
Breast implants are "safe" according to the best information available today. That does not mean that the body does not react to this foreign material. The bed in which an implant is placed, in a woman who has had a mastectomy, is scarred and missing skin. Unlike reconstruction using natural breast tissue, the body reacts to a breast implant by isolating it (forming a capsule or scar around the implant) and then trying to squeeze it into the smallest possible space. This is what happens when capsular contracture occurs, and it can be both physically uncomfortable and aesthetically unattractive.
This 51 year old underwent bilateral mastectomy and implant reconstruction 11 years ago. While initially the reconstructions were "good," over the years the breasts became harder, painful, and changed shape. Despite the fact that this patient was a diabetic, she was able to undergo removal of both implants and have bilateral DIEP flap breast reconstruction. At the time of the surgery it was discovered that one of the silicone implants was ruptured.
Both implant manufacturers and plastic surgeons take elaborate steps to try and modify the scar formation which is a normal reaction of the body. Even with advances in breast implant technology and surgical techniques, a breast reconstructed with an implant can become hard, contracted, and misshapen. The firmness also can be uncomfortable in many women.
With the DIEP flap technique, there is no reaction by the body because no foreign material was used.
To find out more about techniques used for breast reconstruction on Long Island and in the New York metro area, click here to request a phone consultation from Dr. Keller, a renowned plastic surgeon specializing in reconstructive flap procedures.