There are many options available to the post-mastectomy patient. Consultation for an extended period of time is necessary since the personality as well as the anatomy of the patient must be taken into consideration. The most common techniques used today are direct insertion of a high viscosity silicone implant, tissue expanders, and flaps that use muscle and skin from the back or abdomen.

If a nipple has been lost, a new one can be created by tattoo or grafting. I prefer tattooing.

Some patients do not require preliminary tissue expansion before receiving an implant. For these women, the surgeon will proceed with inserting an implant as the first step.

In two types of flap surgery, the tissue remains attached to its original blood supply. The flap, consisting of the skin, fat, and muscle are tunneled beneath the skin to the chest, creating a pocket for an implant or, in some cases, creating the breast mound itself, without the need for an implant.

Another flap technique uses tissue that is surgically removed from the abdomen, thighs, or buttocks and then transplanted to the chest by reconnecting the blood vessels to new ones in that region. This procedure requires the skills of a plastic surgeon who is experienced in microvascular surgery as well.

This implant is designed to conceal the presence of abreast implant. It prevents the appearance of ripples and indentations that are all too common in thin woman. It has been used extensively on patients that have had radical mastectomies and are left with thin skin coverage.

The Inamed 410 Cohesive gel implant is not a new implant for it has been used in Europe since 1994 where it is now Inamed's most popular implant. What makes this implant different from previous implants? The shell is Inamed’s biocell textured shell used in their saline and silicone implants. What has changed is the concentration of the ingredients in the silicone gel filler. The ingredients are no different. What is different is the “cross-linkage” of the compounds. This change in concentration gives the silicone filler the consistency of a “gummy bear” candy. It is harder to fold or indent and in the odd chance of rupture the gel does not leave the implant shell.

Participants in the study must have had previous breast surgery with a poor outcome or have a birth defect or cancer surgery.

Eligibility can only be determined after a thorough an in-person history and physical examination. Though this is a study, the usual breast augmentation charges apply. However, the company gives patients a stipend for completing their annual follow-up, which, after ten years comes close to covering the cost of the device.

Dr. Gary Manchester, a board certified plastic surgeon and graduate of Harvard Medical School, is one of only two physicians in SouthernCalifornia to perform this procedure. His practice, Manchester Clinic of Plastic Surgery, is located in San Diego. Manchester explains that the implants are safer and do away with visual defects, such as defining edges and unnatural fluid movements.“Often times people with saline implants have rippling, and the implant can be seen through skin, especially cancer patients who have very thin skin because of surgeries. Normal saline implants ripple after only three to four years. When a woman is undressed you may see a fluid wave. This cohesive silicon does not move or reveal its presence. If it were cut it would not leak and it is very soft.”