Tissue Expander-to-Implant Reconstruction

In tissue expander-to-implant reconstruction (two-stage reconstruction), an expander is placed in the breast pocket after the mastectomy and prior to the implant. Saline is then added to the expander via a port until the desired breast pocket size is achieved. This requires a second operation to later swap the expander for a permanent implant to create the breast mound.

It is important to note that when a tissue expander is being filled, the patient will often feel a stretching sensation and tightness within the breast. This can be uncomfortable for a few days, but it should not be painful. The expander is generally inflated until the new breast is just larger than the other one, and then left for a few weeks so the skin stretches. Some of the fluid is then taken out through the port, causing the new breast to droop slightly, in an effort to mirror the other breast.

Once the desired breast pocket is achieved, the expander will be taken out and swapped for the final permanent implant.

A permanent expander implant may also be utilised. Similarly, the permanent expander is gradually inflated over several weeks and left slightly over-inflated to allow the skin to stretch. When the patient is happy with the shape and size of her breast, any excess fluid is removed to try to match the reconstructed breast. The port is then taken out under local anesthetic, leaving the expander implant in place.

Shorter operation
Shorter hospital stay
Quicker recovery
No donor-site complications (such as muscle weakness, pain, bleeding or infection)
Fewer scars
May be less painful versus autologous reconstruction
Avoids a second operative site
Allows surgeon greater control of the final breast shape (an improved aesthetic result)
Allows surgeon greater control of the final location of the implant
Possibility of multiple operations
Foreign implant in patient's body could lead to complications
Risk of scar tissue formation and capsular contracture (particularly in radiated breasts)
Possible differences in size and shape of both breasts
Bleeding, pain, wound infection and bruising may occur after operation
Risk of damage or rupture of the implant
Risk of infection and implant loss
Risk of injection by the body
Potential skin flap damage if the tissue is over expanded


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IMPORTANT INFORMATION: Every patient is different and their reconstruction options and their results may vary. All depictions on this site are for illustration purposes only. Whether or not a patient has breast reconstruction is a decision to be made in consultation with a healthcare professional. Only the patient and health care professional can determine the best option for reconstruction.
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