Tissue Expanders Reconstruction

Breast Reconstruction Program

The Surgery

Tissue Expanders Reconstruction

Note: Before-and-after surgery photos follow the reconstruction descriptions. These photos may upset some people, however, the intent is to inform women who are in the process of making a decision about whether to undergo breast reconstruction.

*If you feel that the photos will distress you, please do not scroll down.

Tissue expanders (adjustable implants) are placed behind the chest muscle (pectoralis muscle) to stretch the muscle and skin until the new breast mound reaches a size that is slightly larger than the natural breast. The partially inflated expander is inflated in stages weeks following surgery after the surgical site has healed. Small amounts of saline solution (salt water) are used to inflate the expander via an incorporated valve. A second surgery is required (out patient surgery) to remove the expander and replace it with a permanent breast implant

Some expanders are designed to be left in place and are not replaced with an implant.

Advantages of this procedure

Disadvantages of this procedure

Surgery time, hospital stay, pain and return to normal activities

The surgery takes about 2 hours depending on whether it is delayed or immediate, unilateral (one side) or bilateral (both sides) reconstruction and whether the remaining breast requires reduction or lifting (mastopexy) surgery.

Before and After Photos of Tissue Expander Procedure

This patient previously had a right mastectomy and delayed tissue expander surgery. No surgery was required to the opposite breast as its shape matched the reconstructed breast. Approximately four months after placement of the tissue expander, the device was removed and replaced with a permanent implant. At this time the nipple was made and the areola was tattooed later.

Breast Reconstruction

Possible Complications of Tissue Expander Procedure

NOTE: While the photos of complications may upset some people, the intent is to inform women who are in the process of making a decision about whether to undergo breast reconstruction.

Complications after tissue expander reconstruction

It is important to know that complication rates decrease as plastic surgeons develop more expertise in doing the surgery.

Complications with breast reconstruction are similar to those associated with any type of surgery:

1. Bleeding (hematoma)

2. Problems with a general anesthesia

3. Seroma (collection of fluid under the wound)

4. Infection
Although significant wound infections are rare, when they do occur antibiotics are used to treat them. However, if infection persists, the implant may have to be removed and when this happens, further reconstructive attempts should be delayed a minimum of 3 months

5. Capsular contracture
Fibrous tissue may form around the implant cause tightening and hardening and change in implant shape. Capsular contracture may occur within months or years after reconstruction. In some cases, it may be necessary to remove the implant and replace it with a new one. There is a higher incidence of capsular contracture if radiation is involved.

7. Implant displacement or rupture
This may occur and surgery to replace the implant may be required. Mammography, ultrasound and MRI can be used to investigate a suspected rupture. However, the only certain method to establish that a rupture has occurred is surgical investigation

8. Breast asymmetry
The most common shortfall for implant reconstruction is the difficulty of matching the opposite breast in shape, size, and sensation with the implant devices currently available.

9. Delayed wound healing caused by smoking

10. Thinning of the stretched skin may cause wound healing problems

11. Valve problems can also occur

* Radiation before or after the mastectomy surgery increases the risk of complication.

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