Tissue Expanders for Breast Reconstruction
What are Tissue Expanders?
Sometimes a patient’s best option for breast reconstruction is through a saline breast implant rather than the DIEP Flap procedure. Most commonly, this occurs when there was a large amount of tissue removed during a mastectomy, or if there is an insufficient amount of donor tissue available from the chest or abdomen, or the abdomen contains a large amount of scar tissue from previous surgeries.
Tissue Expander Procedure
The Tissue Expander procedure is a multi-step process that occurs over several months before the permanent saline breast implant is placed. Many women opt to begin the breast reconstruction process immediately following their mastectomy, although some prefer to wait until chemotherapy and radiation are completed. With either option, the first step in the process is to encourage additional tissue growth to create a natural pocket for the implant.This is achieved by inserting tissue expanders, which resemble empty saline breast implant pouches, and later filling them with saline solution to encourage new tissue growth. After a two to three-week recovery time, the expanders are filled with a saline solution that places pressure against the surrounding tissues, encouraging new cell growth which will create the natural pocket for the later insertion of the permanent implant. When the natural pocket has reached the optimum size and shape, the tissue expanders are removed and permanent implants are inserted.
What are the Advantages of Tissue Expanders?
- Shorter procedure
- Shorter hospital stay
- Shorter recovery time
- Produces relatively predictable breast shapes in most women
- Little scarring
What are the Disadvantages of Tissue Expanders?
- Less natural breast shape
- The expansion process is time-consuming and may be inconvenient
- The final breast shape is not immediate
- After radiation therapy, the skin may not respond well to the expansion process
- An implant reconstruction may not respond well to subsequent radiation therapy
- The process involves more than one surgery
- The expanders and implants can migrate
- The expanders and implants can rupture
- Capsular contractures are possible, which requires additional surgery to correct
- Implants can wrinkle or ripple, creating a less than natural appearance
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