Silicone implants
for breast reconstruction
Interview Angelika Demmerschmidt (Mamazone) with Prof. Dr. med. Nina Ditsch, specialist in obstetrics and gynecology at the University Hospital Augsburg
What are the advantages of using silicone implants for breast reconstruction?
Prof. Dr. med. Nina Ditsch: Each case is unique, and the choice of method depends on the patient's personal preferences. The main advantage of silicone implants is that they do not require intervention in other parts of the body, making the surgery less burdensome and reducing the size of the incisions.
Who are implants suitable for, and who should avoid them?
Prof. Dr. med. Nina Ditsch: Implants are best suited for women with normal or slightly drooping breasts and a normal body mass index. If the breast has sagged significantly, implants may only be used in combination with other procedures, such as breast lift. Women with a large breast volume may benefit more from reconstruction using their own tissue.
What is the significance of different implant coatings?
Prof. Dr. med. Nina Ditsch: Different implant textures can affect the risk of developing capsular contracture—hardening around the implant. Textured implants were developed to reduce this risk. However, their impact on the risk of developing rare types of lymphoma is still being studied.
Does radiation influence the choice of reconstruction method?
Prof. Dr. med. Nina Ditsch: The choice of method may depend on the need for radiation therapy after surgery. In some cases where radiation is required, using one's own tissue may provide a more stable result.
Where are implants placed—under the muscle or in front of it?
Prof. Dr. med. Nina Ditsch: Implants used to be placed more often under the chest muscle, but now they are increasingly being placed in front of it. This is due to improvements in surgical techniques and a desire to avoid certain problems, such as "jumping breast" (formation of folds in the breast when the chest muscle is tense).
Why are titanium meshes used when placing implants?
Prof. Dr. med. Nina Ditsch: Titanium meshes are used for better fixation of the implant and to reduce the risk of complications. They promote healing and can be used in conjunction with other materials to achieve a better result.
When is it better to do breast reconstruction—immediately after tumor removal or later?
Prof. Dr. med. Nina Ditsch: This decision should be made individually, depending on various factors including the stage of cancer and the patient's preference. In some cases, it can be done immediately after tumor removal, while in others, it may be better to wait.
What complications can occur after implant placement?
Prof. Dr. med. Nina Ditsch: Possible complications include capsular contracture, seroma, infection, and skin necrosis. The risk of these complications depends on various factors, including overall health and adherence to post-operative recommendations.
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