What are tissue expanders?
Tissue expanders are temporary breast implants used to gradually expand and prepare the skin and muscle for a permanent implant or micro-vascular flap reconstruction. It is a common procedure for women who have had mastectomies and wish to reshape the breasts.
These temporary implants can be placed underneath the pectoral muscle (sub-pectoral) or over it (pre-pectoral). Sub-pectoral is the most common form of this procedure, but some women may be candidates for pre-pectoral expanding, depending on anatomy.
Tissue expanders are generally implanted during the time of the mastectomy - which is known as immediate reconstruction - but can also be implanted in women who have already had a mastectomy in the past. This is known as delayed reconstruction.
Types of tissue expanders
In the past, expansion of the temporary implant was typically performed by injecting saline into a valve in the expander. This method requires regular visits to the plastic surgeon over several weeks.
However, there is now a new method: pumping the expander with air. In this method, the doctor will inject carbon dioxide into the pumps instead of saline, which achieves the same effect while feeling lighter.
In some cases, patients can now be sent home with a device called an “Airxpander,” which allows them to inflate the expanders themselves at home by pressing a button.
What to expect after Tissue Expander
During the consultation, the patient and his doctor will discuss all options, as well as the timing of the procedure, recovery and the patient’s preferred breast size. The plastic surgeons will work with the patient to ensure she is informed, comfortable and happy with the results.
In order to expand the implant and gradually stretch the breast, the temporary implant is enlarged over time. This is done by pumping saline solution or air - depending on the type of expander used - into a valve in the expander over the course of a few weeks or months.
Complications related to Tissue Expander
Tobacco use and radiation are often associated with increased risk of complications after tissue expander surgery. The doctor will discuss some unique risk factors with the patient during her consultation.
There are a number of risks of having this procedure, including:
If there are complications with the patient’s tissue expander placement, she may be at increased risk for complications with a permanent implant and reconstruction.
After the procedure, patients are typically hospitalized overnight. It is common for the breasts to fill with fluids directly after the surgery to avoid this the plastic surgeon will insert drains, which will be kept for one to two weeks as the breasts heal.
After that period, the drains are removed, and expansion can begin. It is recommended that patients avoid stress, heavy lifting, excess physical activity and any friction or abrasion at the incision site during recovery.
There may be some discomfort during tissue expansion. After 2 to 3 months, another surgery will be necessary to remove the expanders and exchange them with the permanent implants.