Other than timing, the various techniques of reconstruction must be considered. Some use implants, others use a woman's own tissues in addition to or instead of an implant.
Over the past few years, isolated cases of possible reactions to silicone gel leading to autoimmune diseases have been reported. While these reports are being investigated, silicone gel implants are no longer available for routine breast reconstruction and augmentation. Except for a limited number of gel-filled implants used by specific clinical investigators, inflatable silicone implants filled with saline (sterile salt water) are now being used.
The most common complication following silicone breast implantation has historically been capsular contracture. In up to half of women, the normally thin layer of scar tissue surrounding the smooth surface of the implant thickens and contracts. This creates an abnormal firmness and sometimes pain and/or distortion of the breast. This problem has been particularly prevalent when the implant is placed on top of rather than underneath the chest wall muscle. Capsular contraction often can be corrected with additional plastic surgery.
