Am Fam Physician. 2021;104(5):online
See related article on breast implants
What are breast implants?
Breast implants are fluid- or gel-filled devices that are put into your chest to change the shape or size of your breast. Most breast implants are used after breast cancer surgery (mastectomy) or when women want to increase their breast size (augmentation).
What are the types of breast implants?
Breast implants are filled with saline (salt water) or silicone (gel) and come in a variety of sizes. Most women choose silicone-filled implants because they have a more natural feel. However, it is easier to tell if saline implants break open, and the saline is easily absorbed by the body.
Should I have the implant above or below the chest muscles (pectoralis)?
Implants can be placed above or below the chest muscle, depending on a conversation with your surgeon; each has advantages. Placement above the muscle decreases pain after surgery. Placement below the muscle is more common after breast cancer surgery, has lower rates of infection, and has a lower rate of long-term complications. Disadvantages of implants placed below the muscle include abnormal upward movement of the breast tissue when the pectoralis muscle contracts.
What can go wrong with my implants?
Infection: You can have an infection of the incision after surgery or of the implant. Most of the time, infections are treated with antibiotics, but sometimes you will need the implant removed.
Contracture: Scar tissue around the implant can cause the breast to feel hard or become painful. Sometimes you will need surgery to have the implants replaced.
Leaks/rupture: The material within the implant can leak. If you have saline-filled implants, it will be obvious because the saline will be absorbed, and then the breast will become flat. If you have silicone-filled implants, you may not know that the implant is leaking. The U.S. Food and Drug Administration recommends that anyone who has silicone implants have scheduled ultrasonography or magnetic resonance imaging (MRI) of their breasts to monitor for implant leakage.
Breast implant–associated anaplastic large cell lymphoma: This very rare cancer is more common with implants that have a textured surface (currently not available). Your doctor will monitor you for any signs of this disease. Importantly, breast implants do not cause breast cancer nor do they interfere with the detection of breast cancer.
Where can I get more information?
American Society of Plastic Surgeons