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What is Breast Enlargement with Tissue Expander?

A common breast reconstruction technique is tissue expansion, which involves expansion of the breast skin and muscle using a temporary tissue expander. A few months later, the expander is removed and the patient receives either microvascular flap reconstruction, or the insertion of a permanent breast implant. This type of breast reconstruction requires two separate operations.

A Breast Tissue Expander is an inflatable Breast Implant designed to stretch the skin and muscle to make room for a future, more permanent implant.

How does a Tissue Expander Differ?

Tissue Expanders are usually used as a means of Breast Augmentation in cases of Breast Asymmetry when one breast is significantly smaller than the other. The smaller breast is gradually increased in size over the course of a year and then the expander is removed and a standard breast implant is inserted.

The reason for exchanging the tissue expander implant for a normal silicone implant is that the standard implant feels more natural and there is a very small risk of implant deflation (leakage of saline from the valve that allows the salt water to be injected). Although this does not pose any risk from a health point of view it would result in the breast becoming smaller again. If you decide that you are happy with the expander and would like to keep it, then a small operation under local anaesthetic is needed to remove the injection port site.

How Does Breast Enlargement with Tissue Expander Surgery Work?

At the same time your Mastectomy is done by our breast surgical oncologist, Mr Khan will insert a Tissue Expander beneath your skin and chest muscle. Through a tiny valve mechanism located inside the Expander, the nurse practitioner will periodically inject a salt-water solution to gradually fill the Expander over several weeks or months. You may feel a sensation of stretching and pressure in the breast area during this procedure, but most women find it is not too uncomfortable.

This process will usually begin three to four weeks after your Mastectomy, once your drains are removed, and will continue until the size is slightly larger than your other breast. After the skin over the breast area has stretched enough, the Expander will be removed in a second operation and either Flap Reconstruction or a Permanent Implant will be inserted. The nipple and the dark skin surrounding it, called the Areola, are reconstructed in a subsequent procedure.

The operation usually takes between 60 to 90 minutes.


Recovery after Breast Enlargement with Tissue Expander Surgery

It can take about 6 weeks to recover from implant surgery done at the same time as Mastectomy. It's important to take the time you need to heal. It's also important to continue doing your arm exercises each day and follow any other routines Mr Khan or physical therapist prescribes for you.

When you have surgery to swap the Tissue Expander for a Permanent Implant (the second step of delayed-immediate or delayed reconstruction), it's usually done as an outpatient procedure, which means you don't stay overnight in the hospital. You'll still be given general anesthesia, so you'll need to have someone come with you to the hospital or clinic to drive you home. This surgery takes about an hour. Because this surgery is less involved than the Mastectomy-Tissue Expander / Implant surgery, recovery usually takes about 2 weeks.


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