Prosthetic breast implants are used for cosmetic breast enlargement, correction of asymmetries and congenital defects, as well as for breast reconstruction in women who undergo mastectomy for breast cancer or cancer risk reduction. Breast augmentation is the most common cosmetic surgical procedure performed in the UnitedStates with 296,203 procedures performed in 2010.
Among women who undergo mastectomy, 10% to 20% have a reconstructive procedure and choose prosthetic implants, instead of autologous tissue reconstruction, 80% to 90% of the time.
Breast implants may be placed between the pectoralis major muscle and the breast gland (subglandular) or under the muscle (submuscular). In cases of breast reconstruction, the implants are typically placed entirely under the muscle through the mastectomy incision although either the subglandular or the submuscular position may be used for non reconstructive procedures. For cosmetic purposes, the surgical approach is most commonly through an inframammary or periareolar incision and less commonly using a transaxillary,t ransareolar, or transumbilical incision. When performed for reconstruction after mastectomy, breast implants can be placed at the time of mastectomy (single-stage) or more commonly at a later time point (two-stage).