If I increased from a size Full B/Small C to a Full D (this is following a Mastectomy for ductal carcenoma) and the doctor plans to use Alloderm or Neoform, would a Saline or Silicone Breast implant be best? I'm so confused about this issue and the time is almost here. Thank you.
Saline or Silicone Breast Implant After Mastectomy?
Doctor Answers (6)
Breast reconstruction-implant type
Thank you for your question.
It is difficult to say which implant is best for your situation without being able to examine you. As already stated, silicone feels more natural than saline which is especially nice when replacing an entire breast or not having much tissue to work with. Flaps are often an option as well. There are pros and cons to all of the options. You should discuss with your surgeon which option is best for you.
What type of implant is best for reconstruction?
The usual rule is that silicone feels more natural, both in reconstruction and augmentation. However, there may be circumstances unique to your situation. For example, if you surgeon believes that a shaped rather than round implant is preferable, those are only available in saline until the FDA releases the Allergan Style 410 and Mentor CPG. Most of the time the round implants work very well, and the Alloderm helps with coverage. It sounds like your plastic surgeon is up to date with the latest techniques so I am sure you are in good hands, which is more important than type of implant.
You should fully discuss this with your plastic surgeon who should be able to sort out all the variables. There is no one right answer which is why you are probably confused. The reconstruction should be intimately planned with the mastectomy and often the reconstructive goals may influence the type of mastectomy greatly. Make sure your plastic surgeon and general surgeon communicate closely.
In general, a silicone implant reconstruction, when it works, will fell more natural than a saline implant, especially the larger you go. However, if you need radiation, silicone implants will frequently develop capsular contracture. While most total mastectomy patients will not need radiation, some cancers in certain patients may end up receiving radiation and so the game plan might need to be altered. Sometimes the decision about radiation cannot be determined until after the mastectomy and pathology is completed. In this case, a tissue expander might be a logical first stage procedure at the time ofthe mastectomy.
On occasions, a flap (usually a latissimus dorsi myocutaneous flap from the back) is necessary or advisable to supplement the implant to give a more natural feel and appearance. This may be the case if you decide to go rather large and depending on what size the opposite breast is. It is hard to match a completely implanted reconstruction to a more natural opposite breast and the flap is helpful to achieve this.
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Implant selection post-mastectomy
The choice of implant after mastectomy is entirely up to you and your doctor. You should have a thorough exam and discussion about your recontructive options. Saline or silicone implants are dependent upon your desires.
Please discuss this with your surgeon
You a question that only can be answered after full evaluation and breast examination. There are many option for breast reconstruction. These include implant reconstruction and autologous reconstruction.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.