Breast Reconstruction: What Are Tissue Expanders?
Of the many techniques that are used in breast reconstruction, tissue expanders are the most common. Using this technique, the size of the breasts are increased using temporary tissue expander devices. When the breasts expand to the desired size, the tissue expander is surgically removed and replaced with either permanent implants or flap reconstruction.
Combining breast implants with tissue reconstruction is best suited for women who lack sufficient natural body tissue to accommodate an implant or breast reconstruction.
Breast Tissue Expander: What Are They?
The breast tissue expander is a temporary implant that is used to increase the volume of the breasts to accommodate permanent implants. The breasts are removed by a surgical oncologist and an expander is inserted by a reconstructive surgeon.
There is a small valve mechanism within the expander. Periodically, the volume of the tissue is expanded through the insertion of controlled volumes of saline. The target volume is reached over the course of a few months.
Controlled inflation begins a few weeks after the mastectomy when the drains are removed. It is common to feel a pressure build up in the breasts when the tissue expanders are inflated. When the breast sizes match, the saline injection is stopped. This indicates that the skin tissue is stretched sufficiently to accommodate an implant.
Stages in Tissue Expander and Implant Surgery
There are three stages in a tissue expander and implant surgery. The first stage is when tissue expanders are temporarily placed under the chest wall to stretch out the covering skin and muscle creating a pocket. The insertion of a tissue expander can be immediate (immediate reconstruction) or after a few months (delayed reconstruction).
Stage 1: Tissue Expansion
In both cases of delayed or immediate reconstruction, tissue expanders are placed under the pectoralis major muscle. The muscle sheaths the upper portion of the implant and the lower half is covered by AlloDerm®.
In the past, the muscle offered sole covering to the implant. AlloDerm® was utilized because traditional methods were were’t as comfortable and took a long time to reach the required size. AlloDerm® creates a hammock like covering over the expander and improves the contours of the breasts.
Saline is injected into the expander through the built-in frontal port. Each breast has an additional pair of drain tubes and a pain catheter. The latter allows administration of medication to alleviate the pain triggered by expansion and the former drains out excess fluids.
Stage 2: Removal of Expander
Tissue expanders are removed when the desired size is reached. The air pocket created is softened by the excision of scar tissues and new implants are placed. The choice of implant depends on the patient’s requirements and the surgeon’s expertise.
Stage 3: Nipple Reconstruction
Nipple reconstruction is either combined with other final contouring procedures or is done alone. It applies the finishing touches and it will make your overall results look more proportional and aesthetically pleasing.
Contact Our Office
Interested in learning more about tissue expanders? Contact our office today to schedule a consultation with Dr. James Hardy, a board-certified plastic surgeon. He will address any questions you have about the procedure and explain its benefits.