Following mastectomy, a tissue expander is placed underneath the pectoralis major muscle. Once expansion is completed, an outpatient procedure is performed to replace the expander with a permanent saline or silicone implant. A wide variety of saline and silicone implants are available to suit the patient's preferences and body type. Some patients may be candidates for a single-stage implant reconstruction, in which the permanent implant is placed at the time of mastectomy.
Using implants for breast reconstruction works well for patients who do not want to undergo tissue flaps which require longer operative time and recovery. Some patients are not candidates for tissue flaps, but will do well with implants. With good quality skin coverage, implant reconstruction can achieve a pleasing, natural appearance without placing scars on other parts of the body. Disadvantages of implants include the need for multiple operations and the possibility of scarring around the implant (contracture), implant rupture, and infection. Patients who have had prior radiation therapy are usually not candidates for reconstruction with an implant alone.