Tissue Expander
Breast Reconstruction with Implants

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.

Breast Reconstruction (Tissue Expander)
Procedures by Stephen Madry, M.D.
© 2013 Stephen A. Madry, MD. All Rights Reserved.
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