Breast implants are made of a flexible silicone casing filled with either saline (sterile salt water) or silicone gel (a soft gelatin-like substance). Implants come in a wide variety of sizes and shapes. Many women find that silicone gel implants feel softer and more like a natural breast than saline implants. Both types of implants are considered safe, as approved by the U.S. Food and Drug Administration.
Tissue Expander Process
Breast implant surgery is usually a two-step process. First, your surgeon inserts a tissue expander (like an empty balloon) under your chest muscles. Over several weeks, we inflate the expander until we reach the size and shape that you want. Then your surgeon performs a second surgical procedure to replace the expander with the saline or silicone implant of your choice.
Your surgeon may recommend a new approach for you, if you are eligible, called direct-to-implant breast reconstruction. Direct-to-implant surgery avoids use of a tissue expander. Your surgeon inserts the implant immediately behind the pectoralis major muscle, using innovative techniques to provide additional soft tissue support.
If you do not have enough skin and muscle to cover the implant, we can stretch the existing tissue over time with a tissue expander or AlloDerm® (an acellular tissue matrix), which your surgeon can explain. We may need to perform an additional procedure to improve symmetry, size, or shape of the breast.
At Mount Sinai, we stand at the forefront of breast reconstruction surgery. C. Andrew Salzberg, MD, Chief of the Division of Plastic and Reconstructive Surgery at The Mount Sinai Hospital and Professor of Surgery at the Icahn School of Medicine at Mount Sinai, pioneered the direct-to-implant approach. He and our other highly skilled reconstructive surgeons are available to advise you about this option.