Although breast implants generally work well for cosmetic breast augmentation in women who have not undergone mastectomy, inherent problems with their use in breast reconstruction may make this kind of breast replacement a less desirable choice for many women.
Why is there such a difference when both procedures use implants? First, women who have implants placed for cosmetic breast enlargement have natural breast tissue that covers the implants and acts as a protective layer helping to prevent the capsule that invariably forms around an implant from being noticeable. When all of the breast tissue has been removed by mastectomy, only a thin layer of skin remains. The absence of breast tissue after mastectomy can make it more difficult to achieve a natural look and feel using breast implants. Second, since a synthetic implantable prosthesis has a fixed shape and cannot be sculpted, if a woman is having only one breast reconstructed with an implant, it may be difficult to achieve a satisfactory degree of symmetry with the natural breast. It is difficult to match an implant to the shape of the other breast’s natural tissue.
Although complications and unplanned reoperation also happen after cosmetic breast augmentation, they occur much less frequently than after implant reconstruction.