For a majority of women, breast reconstruction with either implant or their own tissue can both lead to a satisfactory result. The decision for reconstructive type is then frequently based on the likely short and long term outcomes of the chosen reconstruction given their clinical history and cancer status. Although every woman’s case will be different, there are certainly some common themes in breast reconstruction as to who will do better with one type of reconstruction from a cosmetic standpoint. The selection of the best type of breast reconstruction is usually related to the woman’s physique and breast shape.
For implant based reconstruction, the best and most predictable results come in women who are very thin, normal weight, or slightly overweight, are small or medium breasted with very little sag to their breasts, and are having both breasts removed. Implant reconstruction in this scenario can lead to a cosmetically good, symmetric breast reconstruction.
For most other women, using their own tissue for reconstruction is likely to have a better long-term cosmetic outcome, assuming they have enough tissue in their abdomen to reconstruct a breast. This is especially true for women with larger breasts, those who have undergone previous radiation therapy, and those women who are having only one breast removed. The abdominal tissue is generally better able to appear like a natural breast, whereas an implant does not usually match well with a mature breast.