If the best option for you is a staged reconstruction,
you will most likely receive a temporary tissue expander
at the time of your mastectomy.
During mastectomy, the surgeon creates a pocket,
generally behind the chest muscle where a temporary tissue
expander may be placed.
At the time of surgery,
the surgeon will insert small surgical drains for
your body's natural healing fluid.
Through a port located inside the expander,
the team will periodically inject saltwater solution
to fill the expander over a few months.
The expander gradually stretches the muscle and
skin in preparation for
either an implant or tissue reconstruction.
After the skin over the breast area has stretched
to the appropriate size,
the expander will be removed in a second operation and
the final reconstruction will be performed.
Most often, we place a sheet of collagen,
a material that is natural in your body as reinforcement for
the tissue expander.
This is called an acellular dermal collagen matrix in which
blood vessels grow in over time becoming a part of you.
This provides an internal bra of sorts or a sling to support your
reconstruction by preserving the fold under the breast.
The whole process can take weeks to months and is different for
each individual, depending on whether treatment such as
chemotherapy or radiation therapy are required.
The tissue expander is always temporary,
hospitalization is usually overnight.
And women are usually back to work within two to four weeks,
depending on the type of job.
There is some discomfort with the expansion process,
because it is stretching the chest muscle,
but most women find that it is most sore in the first couple
of weeks improving over time and is overall very well tolerated.
The drains will remain in for one to two weeks.
At Johns Hopkins,
your experienced breast reconstruction team will do
everything possible to make your breasts look and feel as natural
as possible and will be able to answer any of the questions or
concerns at any time throughout your treatment.