There is more than one method to reconstruct the
breast. One technique is to use a tissue expander,
followed by a breast implant. Breast reconstruction
using tissue expanders and implants has been
performed for over 30 years. A tissue expander is a
device that is made from elastic silicone rubber. It
is placed under the skin of the chest at the location
of the breast. This procedure can be performed
immediately (at the time of mastectomy) or it can
be delayed for months or years. Over a period of
time, the expander is filled with sterile saline via a
small needle inserted through the skin to a "fill port"
located inside the expander. Gradually, as the saline
is introduced, the overlying tissues expand, much
like a woman's abdomen during pregnancy. This
process creates a new breast-shaped pocket.
Because chest skin is usually numb following
mastectomy surgery, it is possible that you may
not experience pain from the placement of the
tissue expander or the needle during the expansion
process. However, you may experience feelings of
pressure or discomfort after each filling of the
expander. These feelings may last for a few days, as
the tissues stretch. The complete filling process will
require a few visits to your surgeon's office over the
course of just a few weeks.
After a few months, usually four to six, the expander
will be removed and replaced with a breast implant.
This procedure will be performed in an operating room, under anesthesia. The type of breast implant
used will be determined by you and your plastic
surgeon after evaluating the dimensions and shape
of your desired breast. Breast implants are available
in round and contoured shapes, in a variety of sizes,
and can be either saline- or gel-filled.
Because during many mastectomies the nipple and
areola are removed, your surgeon may perform a
procedure to build a new one. This procedure can
be done at the time of the implant exchange or in
later stages. Nipple/areola reconstruction is often
performed by using a graft of skin taken from
another part of the body and, after the breast heals,
is frequently tattooed to enhance color.