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Breast Reconstruction: Immediate and Delayed

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Oncoplastic and Reconstructive Surgery for Breast Cancer

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Breast augmentation with prosthetic implants is a procedure that dates back to the 1950s. Silicone quickly became the preferred implant material because of its inert properties and good tolerance. Techniques and the prostheses themselves have evolved significantly over the years:

  • Initial techniques made use of the injection of silicone liquid directly into the tissues, but serious complications ensued including cysts, ulceration and deformation.

  • The first subcutaneous implants (Edgerton and McClary 1958) induced severe fibrosis, as they were made of a permeable material.

  • Double-lumen implants then became popular. These comprised an internal membrane containing silicone with a smooth outer membrane: the intervening space being filled with saline. They were abandoned at the beginning of the 1990s due to technical problems, particularly leakage.

  • Implants with silicone as both shell and filler appeared in 1963 (Cronin 1963) in the form of an anatomically shaped prosthesis with a Dacron patch attached to the posterior surface. Numerous modifi-cations of this design have since appeared.

Saline-filled silicone-shelled prostheses became commercially available around the same time (Arion 1965), and there are different types:

  • Implants prefilled by the manufacturers

  • Implants filled during the operation with a volume recommended by the manufacturers

  • Implants that allow progressive expansion after surgical insertion; this expansion being performed regularly over several weeks or months until the optimal volume is reached (this type being known as expanders)

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Editors and Affiliations

  1. Institut Curie, 26 rue d'Ulm, Paris, 70005, France

    A. Fitoussi , MG Berry , B. Couturaud  & R. J. Salmon , ,  & 

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(2009). Breast Reconstruction: Immediate and Delayed. In: Fitoussi, A., Berry, M., Couturaud, B., Salmon, R.J. (eds) Oncoplastic and Reconstructive Surgery for Breast Cancer. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-00144-4_5

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  • DOI: https://doi.org/10.1007/978-3-642-00144-4_5

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-00143-7

  • Online ISBN: 978-3-642-00144-4

  • eBook Packages: MedicineMedicine (R0)

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