Implant-based reconstruction

Implant-based breast reconstruction is the most common form of reconstruction used worldwide for women who undergo mastectomy and immediate reconstruction. Recent advancements in implant technology and techniques have meant that excellent cosmetic outcomes can now be achieved, with the benefit of a shorter procedure and inpatient stay when compared to autologous reconstruction. One-stage breast reconstruction, rather than a two-stage technique using an initial tissue expander, has become increasingly popular-aided by the development of various biological and synthetic meshes which provide internal support for the lower pole of an implant and increase the size of the sub-pectoral pocket. In recent years, however, 'pre-pectoral' implant-based breast reconstruction has also emerged as a safe, simpler and widely accepted alternative to sub-pectoral reconstruction in appropriately selected patients. Reducing the rate of complications associated with implant-based reconstruction remains a challenge particularly in the context of radiotherapy. These complications together with more recently identified risks associated with implants, such as breast implant associated-anaplastic large cell lymphoma (BIA-ALCL), support the case for ongoing prospective data collection, in the form of implant registries and large-scale outcome studies.