Breast Reconstruction: What is a Tissue Expander, and Why Do Doctors Use Them?

Every mastectomy case is unique. Some women have breast implants inserted as a concluding aspect of the mastectomy. For immediate reconstruction to be possible, the patient must have enough tissue remaining to cover implants placed over or under the chest muscle. When a large amount of skin and tissue is removed during a mastectomy, reconstruction may have to be staged, meaning it occurs in a series of steps. One of those steps may be the insertion of tissue expanders.

What is a Tissue Expander?

A tissue expander is an expandable sac that is somewhat similar to a deflated breast implant. The surgeon inserts the expander between the skin and the chest muscle after diseased tissue has been removed. Expanders have a port, a small plug that allows the doctor to incrementally add saline fluid over a period of time. Each time fluid is added to the expander, the skin over the breast stretches. It can take two to six months to achieve the desired amount of tissue expansion to accommodate a saline or silicone implant.

Depending on the surgery, a woman may have a tissue expander in one breast or both. Using a small needle, the doctor or nurse injects the expander through its port. Appointments are scheduled every 1 to 2 weeks. Expanders can stay in place for up to 18 months. Women who are unsure about their reconstruction can talk to their doctor about a “fill” schedule and target-size that feels right to them. Because the process occurs gradually, a woman may choose to stop her expansion at any time and have suitable implants inserted for long-term shape.

Life with a Tissue Expander

At first, tissue expanders are empty so the breasts feel somewhat like a deflated balloon. Week by week, the breasts fill out as saline is added to the expanders. The purpose of this process is to stretch the skin. Patients should not expect their breast shape to be ideal while expansion is ongoing. Some say that their breasts look somewhat square early on, and rounder as the skin fills out more. Regardless, shaping is the job of breast implants later on. As breast expanders are increasing in size, it is also very likely that the breasts will look and feel firmer than is natural. Once these devices are replaced with breast implants, shape, look, and feel are much more natural.

Dr. Schierle and Dr. Fine are renowned Chicago breast surgeons who serve women from our local area and around the country. To learn more about breast reconstruction after mastectomy, call (312) 266-6240.

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