Tissue expansion is a process whereby existing tissue overlying the breast is slowly stretched by a balloon-type device to create sufficient tissue with which one can create a breast.
Placement of a temporary breast tissue expander in the chest. The tissue expander can be placed at the time of breast cancer surgery (Mastectomy) or a later stage. Over weeks, the reconstructive surgeon gradually fills the expander with saline solution. During this process, your skin will gradually stretch and grow to make room for a new breast as it expands. Your body will slowly adjust to the growth of the implant in the same manner a woman’s body adjusts to the gradual change of her abdomen when she is pregnant.
Eventually, when the desired size has been achieved, the newly created space can be filled with an appropriate reconstruction. The second stage reconstruction is done at approximately 3-6 months after the desired expanded size has been achieved. The delay allows the tissue to soften and permanently acquire the expanded shape.
The reconstructive options range from prosthetic or implant reconstruction to any type of flap reconstruction. Often we place a silicone implant alone or in combination with a latissimus dorsi flap from the back to provide additional coverage over the implant. The latissimus dorsi flap lends itself well to gradual expansion and allows for added coverage.
Free flap reconstruction with your tissue could also be used to fill the cavity so created for the breast. This type of reconstruction requires a minimum of two operations.
Should you develop complications, wish to delay your nipple and areola reconstruction or want to have alteration in the shape of your breasts, you would need additional surgery.
The initial procedure involves the placement of the expander. Gradually the desired size will be reached during the expansion process. The second or definitive reconstruction will depend on the type of reconstruction decided upon by you and your doctor.
The nipple and areola may be reconstructed at the second stage or a delayed third stage. Delaying the nipple-areola reconstruction allows the breast to settle in the correct shape and allows for a correct positioning of the nipple-areola.