Breast implants have been used by an estimated 1-2 million women since the early 1960's for breast reconstruction after a mastectomy or for enhancing breast size.

The most common types of breast implants consist of a silicone rubber shell filled with sterile saline (salt water) or silicone gel. At this time, breast implants filled with silicone gel are again available for breast reconstruction in New Zealand, as scientific evidence shows there is no pathological contraindication. Saline can also be used to fill the implant because it is similar to the fluids in your body, and will be absorbed by your body should the implant leak or break.

Your surgeon will decide whether your health and medical condition make you an appropriate candidate for implant reconstruction. Women with small or medium sized breasts are the best candidates for implant reconstruction, although larger breasts can be reconstructed with a combination of a tissue flap and an implant.

Breast reconstruction with a saline-filled breast implant usually occurs as a two-stage procedure, starting with the placement of a breast tissue expander, which is replaced several months later with a breast implant.

During mastectomy, the general surgeon often removes skin as well as breast tissue and the nipple, leaving the chest tissues flat and tight. To create a breast shaped space for the breast implant, a tissue expander is placed under the remaining chest tissues.

The tissue expander is a balloon-like device made from elastic silicone rubber. It is inserted unfilled, and over time, small amounts of sterile saline are added by inserting a small needle through the skin to the filling port of the device. As the tissue expander fills, the tissues over the expander begin to stretch, similar to the gradual expansion of a woman's abdomen during pregnancy. The tissue expander creates a new breast shaped pocket for a breast implant. Tissue expander placements occur under anaesthetic in an operating room. The reconstructive surgery operating theatre time is generally about one and a half hours. The procedure may require a 1 - 2 day hospital stay. Typically, you can resume daily activity after two to three weeks.

Because the chest skin is at a premium you may experience feelings of pressure or discomfort after each filling of the expander, which subsides as the tissue expands.

During the first stage of implant reconstruction, the plastic surgeon ensures that the pocket created by the tissue expander is positioned correctly and is the desired shape and size.

Based on the result of the expansion, the surgeon selects a breast implant to replace the tissue expander.

After the tissue expander is removed, the unfilled breast implant is placed in the pocket, and then filled with sterile saline. The surgery to replace the tissue expander with a breast implant (implant exchange) is usually done under anaesthetic in an operating room. It may require a brief hospital stay or be done on an outpatient basis.

The type of breast implant used will be determined by you and your plastic surgeon by evaluating the dimensions and shape of your desired breast. Breast implants are available in round and anatomical shapes in a wide variety of sizes. The contoured breast implants help your plastic surgeon recreate the natural shape of your desired breast.