Breast implants

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Breast implants can be made of natural body tissue or synthetic (man-made) materials. About 80% of breast implants are for cosmetic reasons. The remaining 20% are breast reconstructions after surgery, often for breast cancer.

Natural tissue breast implants

Natural tissue implants are usually only attempted on women who are having breast reconstruction surgery. This will often be after all or part of the breast has been removed as a treatment for breast cancer. Natural tissue is rarely used for women deciding to have breast implants for cosmetic reasons, as the procedure is complicated, has an increased risk of side-effects, and may leave scarring on other parts of the body.

Tissue can be taken from either the back (latissimus dorsi reconstruction) or the stomach (rectus abdominus reconstruction). It is then implanted in the chest and moulded to form a natural breast shape. The procedure uses the skin, fat and muscle of another part of the body to form the breast. It is not possible to create a new breast simply by injecting body fat into the chest. The surgeon must remove and redirect muscle and blood vessels to keep the implanted tissue alive and healthy.

Most women who have natural tissue implants are left with a neat scar running from hip to hip (rectus abdominus reconstruction) or in a horizontal line across the lower back (latissimus dorsi reconstruction). The scar is usually placed low enough to be concealed underneath underwear or a bikini.

Women who choose to have a natural tissue breast implant may also consider nipple reconstruction. If the existing nipple is unaffected by cancer and the implant surgery is performed immediately after a mastectomy (breast removal surgery), it may be possible to transfer the nipple to the reconstructed breast. If this is not a possibility, a new nipple may be created from skin and tissue from another part of the body (often the upper thigh). Some women may prefer to use a synthetic stick-on nipple or have a nipple tattooed onto the reconstructed breast.

Synthetic breast implants

There are two types of synthetic breast implants available in the UK; silicone gel and saline solution. Both are contained in a firm, silicone shell, which is made from a type of elastic called elastomer. Modern synthetic implants have a textured surface to reduce the risk of hardening and deforming (capsular contracture).

Silicone gel implants may be filled with a firm, jelly-like silicone or a softer, fluid silicone. The firm silicone keeps its shape even if the implant ruptures (tears) inside the body. This reduces the risk of the silicone entering the bloodstream. Soft silicone is less likely to wrinkle, making it feel more like a natural breast.

Silicone implants have received a great deal of media attention in recent year, with some reports of unsafe or dangerous side effects. In 1998, the government commissioned an Independent Review Group (1) to look at the available evidence about the risks of silicone breast implants and publish a report based on its findings. The group found no evidence that silicone implants pose a risk to women.

Saline breast implants are filled with a sterile salt-water solution, which can be pre-filled or filled through a valve during implant surgery. As the solution is similar in consistency to natural body fluids, it can be absorbed safely into the body if the implant ruptures. Some women find that saline implants decrease in volume over time and are more likely to deflate. Saline implants are also more prone to wrinkling and can feel or appear less natural than silicone implants.