Tissue Expander & Implant Reconstruction

After your mastectomy (surgery to remove your breast), you’ll have a breast reconstruction surgery using a tissue expander. A tissue expander is an empty breast implant that your surgeon will fill with normal saline over about 6 to 8 weeks until it reaches the breast size that you and your surgeon decided on.

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Tissue Expander Implant Reconstruction

Following mastectomy, one of the techniques performed to reconstruct a breast is called Tissue Expander Implant Reconstruction. A tissue expander is a balloon that is surgically placed after the mastectomy or placed later in time. This procedure can be done in one stage (direct to implant reconstruction or placing the implant during the same mastectomy surgery) or in two stages (tissue expander is placed first, followed by implant placement at a later time). In general, reconstruction with implants following either route has the fewest scars and is the least invasive of all the breast reconstruction surgery options. This procedure usually entails one day in the hospital. During follow-up office appointments, the expander is gradually filled with salt water until you have reached your desired size. If chemotherapy and/or radiation therapy is necessary, once these therapies are completed, the expander is removed and the permanent implant placed. This takes about one hour and is done on an outpatient basis, meaning, you can go home right after the procedure. After healing from the second surgery, a nipple can be created with skin taken locally from the reconstructed breast. A tattoo is added in office to recreate the areola, done by our professional tattoo artist who specializes in creating areolas. Reconstruction with implants can also be accomplished in a single stage. This reduces the number of surgeries needed to complete the reconstruction, but offers less flexibility with size, and entails slightly more risk. Watch the video for additional information about breast reconstruction with tissue expanders.


Tissue Expander Reconstruction Overview

This video provides information specific to tissue expander reconstruction after mastectomy.



Tissue Expander & Implant Reconstruction

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What Timeline Can I Expect My Reconstruction To Follow?

The duration of your reconstruction varies, depending on two variables. First and most importantly, it depends upon your post-operative treatment course (radiation, chemotherapy, etc.). Any additional surgery following your mastectomy and tissue expander will not be performed until this is completed and you have healed. Secondly, the length also depends upon the number of expansions necessary to get you to your desired size. Typically, it is best to wait at least three months from your initial mastectomy before any additional surgery occurs.

We add fluid to the expander at the time of surgery that takes up the excess skin without putting any tension on the skin. This usually results in a breast slightly smaller than you were prior to surgery.

The number of expansions you will needs depends on your desired size and the size you are immediately after surgery. If you want to be the same size as you were prior to surgery, this usually takes 1-3 expansions. If you want to be larger than you were prior to surgery, this may require 3-6 expansions. Each expansion takes place in the office and can be done once a week. If you want to take more time in between expansions, that is okay.

Expansions can be done during chemotherapy, but not during radiation therapy.

Expansions typically begin 2-4 weeks following your mastectomy, given that your skin has healed as expected.

Most women do not have sensation in the area where the expansion occurs. It is possible to feel pressure, but rare that it is painful.

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