Breast Augmentation Technology

Breast implants are regulated as medical devices. The MHRA is responsible for ensuring that breast implants meet appropriate standards of safety, quality and performance, and that they comply with the Medical Devices Directive.

Types of breast implants

Breast implants can contain different filler materials inside a silicone elastomer shell. Only two types of breast implant filler are currently in use in the UK:

The shell can be either smooth or textured. Some clinical reports have stated that the textured shell does help in reducing capsular contracture. You should discuss with your surgeon the option of a textured shell over a smooth shell implant. Some are covered with a polyurethane foam coating. Implants that are not available in the UK are:

Presently the majority of breast implant procedures carried out in the United Kingdom are being done by the major national clinics who may sometimes compromise on the quality of the implant but sell the procedure at a very competitive price. It is very important that you discuss with the clinic the type of implant that you will be used in your procedure. So far, the cohesive gel implants is the most natural looking implant. Some of the top manufacturer of cohesive gel implants are Inamed Corp, Mentor Corp and Eurosilicone. It is important that you find out if the manufacturer offer a warranty on the implant in case the implant ruptures or is defective. Ask if the hospital cost and the cost of the implant will be covered if there is a problem with the procedure.

The Well-Informed Patient's Guide to Breast Reconstruction: Implant-Based Breast Reconstruction

Implant-based reconstruction techniques is becoming women's choice to replace the missing breast volume due to breast cancer.

How are breasts reconstructed? - To add volume to the missing breast, the breast implant is placed beneath the muscle and skin of the chest wall. Because implant based reconstruction does not require removal of tissue from other parts of the body, the procedure is less invasive and does not leave a scar at the donor site. More importantly, the patient does not experience the invasiveness of having another part of her body removed to replace the lost breast tissue. For this reason breast reconstruction using implant instead of autologous tissue-based method is becoming more popular for the patients. Patients should be aware that this exist and they should discuss this option with their surgeon when considering breast reconstruction.

The procedure - The outer shell of all breast implants is made of silicone elastomer. The shell is either filled with saline or silicone at the time of the surgery. Some implants may come prefilled by the manufacturers.

During a mastectomy, both breast gland tissue and some of the overlying skin are removed. To reconstruct the missing breast, both the tissue and the skin must be replaced. If the original breast was a very large one, the skin remaining after the mastectomy may be enough to adequately cover an implant. In those cases, using the remaining skin results in a breast that is smaller than the original one but still adequate. In most cases, however, missing breast skin will need to be replaced in some way. The two most commonly used techniques to obtain adequate skin coverage are tissue expansion and an LD flap. A tissue expander is a balloon-like device that, as it is gradually filled with saline, stretches the breast skin remaining after a mastectomy until there is enough skin to cover an implant without tension. This skin expansion is performed gradually, over a period of about two months, and is inconvenient but usually not painful.

The main advantage of implant-based techniques, compared with autologous tissue-based approaches, is that most or all of the material used to make up the breast volume comes from a box on a shelf. (Although the use of the LD flap to cover an implant entails removal of skin and fatty tissue from the patient's back, the implant itself makes up most of the breast volume.) Therefore, the initial operation for implant-based reconstruction is relatively minor. In general, the risks of the surgery (apart from failure to achieve a successful reconstruction) are also less serious than those of autologous tissue-based reconstruction. Special equipment and subspecialized surgical training are not required, so the breast reconstruction can be done in almost any hospital.

Unfortunately, implant-based reconstruction techniques also have significant disadvantages. The main disadvantage of breast implants is the risk of capsular contracture. The formation of a scar capsule, a layer of scar tissue, around a breast implant is a normal wound-healing response to the presence of foreign material. In some cases, this scar capsule contracts or shrinks over time. If the capsular contracture is mild, the breast will stay relatively soft and retain a relatively natural appearance. However, if the capsular contracture is more extensive, the breast will become firm or hard. It will then look and feel very unnatural. For more information on Breast Reconstruction using the expander method, contact Mentor Corporation or Allergan Inc.