Indications and Controversies for Implant-Only Based Breast Reconstruction

Today's demographic of the breast reconstruction patient is younger, often prophylactic or at an early stage of diagnosis, and is more likely to be bilateral. These factors combined with an increase in breast implant options, internal support matrices, fat transfer, technologies for intraoperative real time assessment of tissue perfusion, and an increasing appreciation for morbidity associated with autogenous procedures have resulted in an increase in the percentage of women seeking alloplastic breast reconstruction. This article discusses the indications for implant-only reconstruction and reviews the authors' approach to the use of adjunctive techniques that are used in most of their patients.