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What Is the Best Type of Breast Implant After a Mastectomy?

July 24, 2023

After a mastectomy as part of your breast cancer treatment, you might choose to have breast reconstruction surgery. You’ll want a breast that looks realistic and won’t need to be replaced after a short time. Which is the better choice: saline or silicone breast implants?

Let’s take a look at what might be best for you.

What Is a Breast Implant?

A breast implant is a pouch surgically inserted under the skin to shape a woman’s breast. Women get breast implants for a variety of reasons:

  • To make their breasts larger
  • To change the shape of their natural breasts, such as to create more cleavage
  • To replace a breast removed surgically due to breast cancer, high risk for breast cancer or another medical reason

While the first two reasons are solely cosmetic, the third is more complex. As part of treatment for breast cancer, or in certain cases to prevent breast cancer, some women have mastectomies — a surgery that involves taking the natural breast tissue away. Many times women keep their skin and nipple.

Surgeons replace the missing tissue with a breast implant. The implant can be filled with either saline, which is salt water, or silicone, which is a rubber-like substance.

Silicone Implants Best for Reconstruction

While silicone and saline breast implants can both work well for women having their breasts reconstructed after mastectomies, silicone is often the better choice.

The latest generation of silicone implants offer a realistic feel, and they hold up well.

The newest products available to surgeons are silicone on the outside with silicone gel within. Their texture is similar to that of natural breast tissue; a breast with a silicone implant behaves and feels in a way much like the breast it replaces did. With a silicone implant, your breast will move with your body. It’s a much better match for the original than saline.

The silicone is highly cohesive, which means it holds together well. In fact, the molecules inside a silicone breast implant are so bonded together that it’s nearly solid, similar to the way a gelatin dessert is: If you slice it, both sides will maintain their shapes.

Pros and Cons of Silicone Breast Implants

In years past, news reports cited instances of breast implants rupturing. In those cases, the filling leaked into the woman’s body. Saline was no issue, since salt water won’t cause harm, but silicone gel could create problems.

That has changed. Ruptures are highly unlikely to happen today. Data over 10 years shows that 92 percent of women have no issue with their silicone implants tearing. While years ago patients were advised to have their silicone implants replaced every decade, that is no longer the case.

If there is a rupture, the newest breed of implants have well-bonded gel and are unlikely to leak into the body, so you might not even know it happened. The issue would cause no pain, and your breast would maintain its shape. For that reason, you’ll be advised to get an MRI five years after the implant to make sure it’s whole, and another three to five years after that. The FDA recommends the screening.

Since silicone gel breast implants feel natural and hold up well, they’re most often the best option for women having breast reconstruction surgery. They look good, they feel good and they last a long time.

Reduce Your Risk of Breast Cancer

Breast cancer is the second most common type of cancer among women in the United States. However, with early diagnosis, breast cancer has a relative survival rate of better than 90 percent. Monthly self breast exams can help you be familiar with how your breasts normally look and feel. 

Download a self-examination guide here

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