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Tissue Expanders

A common breast reconstruction technique is tissue expansion, which involves expansion of the breast skin and muscle using a temporary tissue expander. A few months later, the expander is removed and the patient receives either microvascular flap reconstruction, or the insertion of a permanent breast implant. This type of breast reconstruction requires two separate operations.

Chemotherapy or radiation may be recommended to you by your surgical oncologist following your mastectomy. If you choose to have these treatments it will delay the tissue expansion process by approximately four to eight weeks.

Tissue expander surgery.
Tissue expander surgery.

What is a breast tissue expander?

A breast tissue expander is an inflatable breast implant designed to stretch the skin and muscle to make room for a future, more permanent implant.

At the same time your mastectomy is done by our breast surgical oncologist, the breast plastic and reconstructive surgeon will insert a tissue expander beneath your skin and chest muscle. Through a tiny valve mechanism located inside the expander, the nurse practitioner will periodically inject a salt-water solution to gradually fill the expander over several weeks or months. You may feel a sensation of stretching and pressure in the breast area during this procedure, but most women find it is not too uncomfortable.

This process will usually begin three to four weeks after your mastectomy, once your drains are removed, and will continue until the size is slightly larger than your other breast. After the skin over the breast area has stretched enough, the expander will be removed in a second operation and either flap reconstruction or a permanent implant will be inserted. The nipple and the dark skin surrounding it, called the areola, are reconstructed in a subsequent procedure.

Tissue Expander for Staged Breast Reconstruction

Staged breast reconstruction involves expansion of the breast skin and muscle using a temporary tissue expander. This animation illustrates the process.

 What can I expect for my recovery?

Hospitalization is usually overnight, and recovery takes four weeks. There is some discomfort with the expansion process because it is stretching the chest muscle, but most women find it is not very uncomfortable.