Breast implants, often using an expander, are the simplest way to do breast reconstruction. Implants do a nice job of creating a mound, and in clothes are very satisfactory. Recovery generally is the same as if only a mastectomy is done, which is 2 - 3 weeks.

Breast implants may be either silicone or saline filled. Both do a nice job, but the silicone implants are probably somewhat better in terms of softness and shape.

Implants do have some disadvantages, however:

1. They all break eventually, and have an average lifetime of 15 years. Replacing them is easy, but it does require surgery.
2. There is a risk of capsule contracture. This is a thickening of the breast tissue around the implant, which can make the breast very hard and deformed in appearance. With breast reconstruction, the risk of this is nearly 20%, or one chance in five. If radiation is done, the risk rises dramatically to nearly 100%. I generally do not like to use breast implants in a radiated area, and prefer another method.

Most of the time, an expander balloon is placed under the muscle and skin after the mastectomy. This is an empty balloon, which is gradually filled up over several weeks until the skin is stretched out and large enough to contain the real implant. Then, during outpatient surgery, the expander is removed and the real implant is placed. If work is going to be done on the opposite breast (reduction, lift, or enlargement), it is done during this second procedure.

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Breast Reconstruction Links:
National Cancer Institute - Understanding Breast Cancer Treatment
American Cancer Society - Breast Reconstruction After Mastectomy
CancerBACUP - Understanding Reconstruction of the Breast
American Society of Plastic Surgeons - Breast Reconstruction
INAMED Corporation
Mentor Corporation

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Breast Surgery Procedures:
   Breast Augmentation / Enlargement
   Mastopexy / Breast lift
   Breast Reduction
   Breast Reconstruction
       Implant Reconstruction
       Flap Reconstruction
       Combination Reconstruction