Ask Dr. Elliott: For Breast Reconstruction, Should I Choose Implants or Natural Tissue?

When a woman is diagnosed with breast cancer, she faces a road with many difficult choices – lumpectomy or mastectomy? Should I have breast reconstruction? If so, should I have the reconstruction immediately after the cancer removal surgery or delay it? Which breast reconstruction procedure is right for me? Today, we’re providing some guidance on the last in this string of questions—choosing a breast reconstruction procedure from the many excellent options.

Before they schedule a consultation with me, Dr. Franklyn Elliott, few patients realize how many different breast reconstruction methods there are. Overall, there are two basic categories—reconstruction using breast implants (like the implants used for breast augmentation) and reconstruction using the patient’s own tissue (also called autologous breast reconstruction), in which fat and sometimes skin and muscle from the abdomen, back, or other area are transferred to the chest and shaped into a new breast. In some cases, these two types of procedures can also be combined (such as using a flap of tissue from the back to support a breast implant). While I discuss more details about the various breast reconstruction procedures in my other blogs, today we’ll compare the advantages of implants and natural tissue.

Generally, autologous reconstructions are best for women who…

• Want their results to look and feel especially natural
• Are concerned about whether they will still be happy with their results in the years to come
• Have found a highly experience breast reconstruction surgeon, because the surgeon’s skill contributes largely to the success of this procedure
• Don’t want the annual breast exam that is needed for breast implant patients
• Could benefit from the tummy tuck-like results that a TRAM flap procedure creates
• Want to minimize their risk of complications
• Don’t want the potentially lengthy process of using a tissue expander to develop enough breast skin for an implant
• Are having only one breast reconstructed and are concerned about breast symmetry
• Do not have sufficient skin and chest tissue to support and cover a breast implant

Implant reconstructions, on the other hand, are typically best suited for women who…

• Want to minimize the length of their procedure and the recovery time required
• Don’t want to have an additional scar (most autologous reconstructions use skin from another area of the body, resulting in a scar on the abdomen, back, or other area)
• Have a medical condition in which the longer procedure time of an autologous breast reconstruction carries a higher risk
• Understand and accept that the implants will likely need to be replaced within 10-20 years
• Want their breasts to retain a firmer, more elevated position over time rather than developing a natural sag
• Are having both breasts reconstructed, because symmetry between a natural breast and a breast implant is sometimes difficult to achieve
• Smoke or have a history of circulatory problems which would make them more vulnerable to certain complications of autologous breast reconstruction

These guidelines can get the research and decision-making process started, but ultimately, a woman’s choice about breast reconstruction surgery should be made in conjunction with a board-certified plastic surgeon. For many women, there isn’t one procedure that is “better” than the others, and it becomes a matter of personal preference. To start learning about your options for breast reconstruction or other cosmetic procedures, schedule a consultation with us. Or, to stay up-to-date on the latest plastic surgery news, follow us on Facebook, Twitter, and Google+.