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Breast Reconstruction with Tissue Expanders


There are different techniques for performing breast reconstruction. Factors for deciding which technique to use include body type, medical history, smoking history, previous surgical procedures, physical condition and lifestyle, as well as your own preferences.

Whether you have immediate reconstruction (at the time of your mastectomy) or have to wait until after chemotherapy and/or radiation treatments a—decision made primarily on the recommendation of your oncologic breast surgeon and/or medical oncologist—the next choice is whether to use your own tissue, some type of implants, or a combination of tissue with implants. Implant reconstruction is an excellent choice for many of our patients. The surgery and the recovery are relatively quick, requiring only a short hospital stay of 1–2 days. There are also no extra scars involved or additional areas to heal.

This technique requires several stages. In the first surgery, we place a tissue expander, a balloon-like device, underneath your chest wall (pectoralis) muscle. An expander can be placed at the time of your mastectomy or in a delayed fashion, after you have had the mastectomy and chemotherapy. After we have placed the expander, the tissues must heal for a couple of weeks. Then we gently inflate the tissue expander by injecting saline into a small port under the skin on the chest wall. The injection of saline stretches the skin and chest muscle to create a pocket for a breast implant. After the expander reaches the desired size, we will perform a second surgical procedure, this time on an outpatient basis, during which we remove the tissue expander and insert a permanent implant. Breasts reconstructed with this technique can appear very beautiful and natural. Our patients enjoy being part of the decision-making process during the expansion stage. They get to select the size of their new breasts!

Some women may elect not to have reconstruction, but in our experience, women who have immediate reconstruction find it very comforting to wake up after their mastectomies with breasts. For our patients who need—or want—to wait for reconstruction, they are also reassured to know that we can restore their breasts when their treatment is complete.

Download and read “Tissue Expanders: What to Expect—-A patient-to-patient FAQ about what to expect when having reconstructive surgery using tissue expanders”. Click here.