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Breast Reconstruction Using Implants
Using a breast implant is one option for reconstructing the shape of your breast after mastectomy. There are a few types of breast implants, and other factors to consider before you make your choice.
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What types of implants are used for breast reconstruction?
Several types of breast implants can be used to rebuild a breast.
Most implants in the US are made of a flexible silicone outer shell. The inside contains silicone gel or saline. Other types of implants with different shells and fill materials are being studied, but these are only available if you are taking part in a clinical trial.
It's important to talk with your healthcare team about the benefits and risks of each type of implant.
Saline breast implants
Saline implants are filled with sterile (germ-free) salt water. This type of implant has been used the longest.
Silicone breast implants
All silicone breast implants in the US are made of cohesive gel. This is a thicker type of silicone implant. Silicone gel implants tend to feel a bit more like natural breast tissue.
The thickest of these are called form-stable implants. You might also hear them called gummy bear or highly cohesive implants. They keep their shape even if the shell is cut or broken. They are firmer than regular implants and might be less likely to rupture (break), although this still might happen.
Implant size, shape, and texture
Saline and silicone implants come in different shapes and sizes. They can have a smooth surface or a textured (rough) surface. Any type of implant might need to be replaced at some point if it leaks or ruptures.
Tissue support for implants (ADMs)
Some plastic surgeons choose to use donated human skin or pig skin to support tissue expanders or implants. These are known as acellular dermal matrix (ADM) products.
The human or pig cells are removed before the skin product is placed in your body. This reduces any risk that it carries diseases or that your body will reject it.
ADM products are mainly made of collagen so your own connective tissue can grow over the framework. This extends and supports your natural tissues and helps them grow and heal. ADMs can help support and position the tissue expander or implant.
The use of ADMs in breast surgery first started in the early 2000s. Studies that look at outcomes are still being done. This type of tissue is not used by every plastic surgeon, but it is becoming more widely available. Ask your surgeon if it will be used in your reconstruction and talk with them about the benefits and risks.
How is implant reconstruction done?
This type of reconstruction usually involves at least 2 surgeries.
- The first surgery places a tissue expander under the skin or muscle on your chest. The tissue expander is a balloon-like sac that starts off flat and is slowly filled during office visits until the desired size is reached. The surgeon fills the expander by injecting a salt-water solution through a tiny valve under your skin. This is done every 1, 2, or 3 weeks to fill the expander over several months.
- The second surgery replaces the tissue expander with a permanent breast implant.
You might have other procedures later to improve the final result. These can include creating the nipple and areola or making small revisions to improve the shape and symmetry of your breast.
When do these surgeries happen?
- Immediate reconstruction: Breast reconstruction is sometimes started at the same time as the mastectomy surgery.
- Delayed reconstruction: It can also be started later, in a separate surgery.
You might have a choice between immediate and delayed reconstruction. Your surgical team will talk with you about your options. They will consider your medical history, body shape, cancer treatment, and personal preferences.
Direct-to-implant reconstruction: Either of these options usually involves at least one additional surgery to replace the tissue expander with a permanent breast implant. But a small number of people might be able to have their permanent breast implant put in place at the same time as their mastectomy.
Immediate breast reconstruction starts at the same time as the mastectomy, during the same surgery.
It is usually completed in stages. Most people need at least 2 surgeries in total.
The first stage happens during the mastectomy surgery. First, the surgical oncologist removes your breast tissue. Then the plastic surgeon places a tissue expander under the skin or muscle on your chest. Mesh is sometimes used to hold the expander in place, much like a hammock or sling. The tissue expander starts off flat. It is expanded during office visits until the desired size is reached.
The second stage is a separate surgery to remove the tissue expander and replace it with a permanent breast implant. This is called implant placement. If you need chemotherapy or other cancer treatments first, this surgery can be safely postponed.
You might have additional procedures to recreate your nipple-areola area or revision surgeries to improve the overall look.
If you choose delayed breast reconstruction, your breast mound will be rebuilt after your mastectomy, often months later. Reconstruction starts when your chest is flat.
During the first reconstruction surgery, a plastic surgeon places a tissue expander under the skin or muscle on your chest. This helps make a pocket to put the implant into later. The tissue expander starts off flat and is slowly expanded to the desired size to allow the skin to stretch.
Once the skin over your breast area has stretched enough, a second surgery is done to remove the expander and put in a permanent implant.
You might choose to delay breast reconstruction if:
- You don’t want to think about reconstruction while coping with cancer treatment. Some people choose to wait until after breast cancer surgery to decide about reconstruction.
- You have other health problems. Your surgeon might suggest you wait if you smoke or have other health problems. It’s best to quit smoking at least 2 months before reconstructive surgery. This helps your body heal better after surgery.
- You need radiation therapy. Many doctors recommend that people wait on reconstruction if they will need radiation treatments after their breast cancer surgery. Radiation can cause problems after surgery, such as delayed healing and scarring. It can lower the chances of a successful reconstruction.
A small number of people might be able to have their permanent breast implant put in place at the same time as their mastectomy.
People most often suitable for this type of reconstruction are young, have small breasts, and have no health problems. In this situation, a tissue expander is not used. After the surgeon removes the breast tissue, a plastic surgeon puts in a breast implant. The implant can be put under the skin or muscle on your chest. Mesh is sometimes used to hold the implant in place, much like a hammock or sling.
Is there a risk of illness from breast implants?
In the past, there were concerns that broken or leaking (ruptured) silicone-filled implants could cause health issues such as connective tissue disease, breast cancer, or reproductive problems. So far, studies show that silicone implants do not increase the risk of these health problems, but breast implants have been linked with some rare types of cancer.
Rare cancers
Breast implants have been linked with anaplastic large cell lymphomas and other rare cancers. These cancers can start in the scar tissue (capsule) around the implant.
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare type of non-Hodgkin lymphoma that can develop several years after an implant is placed.
- It happens more often when the implants have textured (rough) surfaces.
- It can show up as a collection of fluid, a lump, pain, or swelling near the implant.
- It can also show up as uneven breasts (asymmetry).
Tell your healthcare team if you have any concerning symptoms such as prolonged pain, swelling, or a change in the shape of your reconstructed breast.
Early-stage BIA-ALCL is associated with good outcomes. It is often treated with surgery to remove the implant and capsule. Radiation therapy may be used if the lymphoma cannot be removed completely. More advanced disease might require chemotherapy and/or other treatments.
There have also been rare reports of other types of cancer forming in the scar tissue around a breast implant. This includes:
- Some types of lymphoma, other than BIA-ALCL
- Squamous cell carcinoma
Can I get implant reconstruction if I need radiation?
If radiation therapy after mastectomy is part of your cancer treatment, you might not be a good candidate for implant reconstruction. You should talk with your plastic surgeon about other reconstruction options, such as tissue flaps.
Other things to consider
Most people do well with breast implants, but there are a few important things to consider as you make your decision.
Your implants might need to be replaced. Implants are not lifetime devices. The longer you have them, the greater the chance that you will need another surgery to remove or replace them.
Problems can happen. Implants can break (rupture). Other problems can also happen, such as infection or pain.
In some cases, scar tissue can form around the implant. This is called capsular contracture. It can make the breast feel firm or change its shape. Many of these issues can be treated with surgery, but not everything can be fully corrected.
You may need MRIs every few years. If you have silicone gel implants, your healthcare team might recommend getting special imaging such as breast MRIs every few years to check for silent rupture. These scans are not always covered by insurance, so it’s a good idea to ask your plastic surgeon if you will need them and what to expect.
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- References
Developed by the American Cancer Society medical and editorial content team with medical review and contribution by the American Society of Clinical Oncology (ASCO).
American Society of Plastic Surgeons. Breast Reconstruction. Accessed at https://www.plasticsurgery.org/reconstructive-procedures/breast-reconstruction on March 10, 2026.
Jagsi R, King TA, Lehman C, Morrow M, Harris JR, Burstein HJ. Chapter 79: Malignant Tumors of the Breast. In: DeVita VT Jr, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 12th ed. Philadelphia, PA: Wolters Kluwer; 2023
Mehrara BJ, Ho AY. Breast Reconstruction. In: Harris JR, Lippman ME, Morrow M, Osborne CK, eds. Diseases of the Breast. 6th ed. Philadelphia, PA: Wolters Kluwer; 2022.
National Comprehensive Cancer Network (NCCN). Practice Guidelines in Oncology: Breast Cancer. Version 2.2026. Accessed at https://www.nccn.org/professionals/physician_gls/pdf/breast.pdf March 9, 2026.
US Food and Drug Administration. Breast Implant Surgery. Updated March 8, 2023. Accessed at https://www.fda.gov/medical-devices/breast-implants/breast-implant-surgery on March 20, 2026.
US Food and Drug Administration. Risks and Complications of Breast Implants. Updated December 15, 2023. Accessed at https://www.fda.gov/medical-devices/breast-implants/risks-and-complications-breast-implants on March 20, 2026.
US Food and Drug Administration. Things to Consider Before Getting Breast Implants. Updated March 3, 2023. Accessed at https://www.fda.gov/medical-devices/breast-implants/things-consider-getting-breast-implants on March 20, 2026.
US Food and Drug Administration. Types of Breast Implants. Updated October 23, 2019. Accessed at https://www.fda.gov/medical-devices/breast-implants/types-breast-implants on March 20, 2026.
Last Revised: July 1, 2026
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