Breast Reconstruction & Breast Augmentation with Implants are Very Different Procedures

Breast implants can be used for either cosmetic breast augmentation in women who have not undergone mastectomy or for breast reconstruction after mastectomy. Inherent problems with their use in breast reconstruction makes breast reconstruction with implants very different than breast augmentation with breast implants.

Why is there such a difference when both procedures use implants? First, women who have implants placed for cosmetic breast enlargement have natural breast tissue that covers the implants and acts as a protective layer helping to prevent the capsule that invariably forms around an implant from being noticeable. When all of the breast tissue has been removed by mastectomy, only a thin layer of skin remains. The absence of breast tissue after mastectomy can make it more difficult to achieve a natural look and feel using breast implants. Second, since a synthetic implantable prosthesis has a fixed shape and cannot be sculpted, if a woman is having only one breast reconstructed with an implant, it may be difficult to achieve a satisfactory degree of symmetry with the natural breast. It is difficult to match an implant to the shape of the other breast's natural tissue. If you are considering breast reconstruction with implants--still the most common method of breast reconstruction in the United States--you may want to educate yourself more about the potential short- and long-term complications of this procedure. Your surgeon should be able to provide you with a booklet printed by the manufacturers of approved breast implants that details the potential complications. The FDA also maintains this information on their website:

Breast Implant Consumer Information

Breast Implants - Potential Local Complications and Reoperations

Photographs and/or Illustrations of Breast Implant Complications

Although complications and unplanned reoperation also happen after cosmetic breast augmentation, they occur much less frequently than after implant reconstruction. Natural tissue generally provides the highest quality and most durable type of breast restoration. The most advanced methods of breast reconstruction available today use natural tissue to restore a breast removed by mastectomy without sacrificing a woman's muscles in the process or requiring the insertion of a synthetic breast implant. Perforator flaps such as the DIEP flap are sophisticated methods of natural-tissue restoration that leave muscle intact at the donor site while still providing the necessary blood supply to the tissue used for reconstructing a breast. This is possible through the use of microsurgical techniques. Without destroying important functional muscles, a new breast from healthy, warm, living tissue. can be shaped to closely resemble the breast removed by a mastectomy. Because they do not remove muscle, perforator flaps are now considered by many experts to be the very best option for natural-tissue breast reconstruction.