Tissue Expander Reconstruction
The road to recovery is not only about your state of health, it’s also about regaining control of your life’s direction. Breast reconstruction surgery is a symbol of that control; it’s a way of combating the damage done by the unfair twists and turns of life. Whether caused by mastectomy, birth defect, or other trauma, damage to the breast tissue can leave psychological bruises, as the breasts are often a symbol of feminine identity. For women who don’t want to lose that aspect of themselves, reconstruction offers a way to get something back. The surgeons at East Coast Advanced Plastic Surgery, often in conjunction with your surgical oncologist, are here to help at the beginning of that journey—and the first step is sometimes a procedure called Tissue Expander Reconstruction.
What is Tissue Expander Reconstruction?
During a mastectomy, for example, nearly all of your breast tissue will be removed. During an aesthetic breast augmentation procedure, implants are placed between the breast muscle and the fatty breast tissue, which forms a kind of natural pocket that, eventually, nicely accommodates the implant. Breast reconstruction presents unique challenges, in that no matter what type of implant is chosen (silicone, fat tissue, muscle tissue, and so on), that nice “pocket” is no longer available.
Tissue expander reconstruction is designed to solve this dilemma with as little discomfort as possible. Sometimes performed during the initial mastectomy, tissue expander procedures insert a small device into the muscle tissue of the chest. This device is essentially a balloon with a strategically located valve that allows surgeons to inject a saline solution into the expander. By slowly expanding the size of the device over the following weeks and months, a pocket can be created for the final breast implant with minimal discomfort.
The follow up procedures, during which your plastic surgeon will increase the amount of saline held in the device generally take about twenty minutes to perform, but can sometimes last longer.
Am I a Good Candidate for Tissue Expander Reconstruction?
Tissue expansion is a vital part of the breast reconstruction process. Candidates are generally a good fit for this procedure if they meet the following criteria:
- You are in generally good physical condition and can withstand the stresses of major surgery
- You have undergone or are planning to undergo a mastectomy
- Your breasts have been damaged or are missing due to lumpectomy, radiation, injury, or birth defect
- Your breast abnormality or trauma causes you to feel less feminine or simply makes you unhappy or unsatisfied
During your consultation with the plastic surgeons at East Coast Advanced Plastic Surgery, we will discuss your goals for the procedure and for the remainder of the breast reconstruction process. Your end goals will be especially important to articulate, as they may determine how large the final breast pocket needs to be. You should, however, be prepared to discuss your full medical history, including current treatments, medications, and allergies, as well as use of alcohol, tobacco, or illegal drugs. All of this information will be considered in determining the right course of action for your particular case.
Special Considerations For a Tissue Expander Reconstruction Procedure
The following factors are important to consider prior to your tissue expander procedure:
Age: Breast reconstruction for breast cancer patients may be performed at any age, but it is best if the breast has fully stopped developing.
Cancer Treatment: Ongoing cancer treatments can affect the optimal timing of certain procedures, and can dictate which procedures are performed at which time. It is important to discuss with your plastic surgeon how your cancer treatment will affect your reconstruction. At times, multiple procedures may be necessary for optimal reconstruction outcomes. In the case of tissue expander, some patients elect to have the expander placed concurrently with the mastectomy procedure in order to most efficiently and quickly into the reconstruction phase.
Pregnancy: It is important to inform your ECAPS surgeon if you are considering having children in the future. Pregnancy can cause bodily changes, which can affect the long-term results of your surgery. Your ECAPS surgeon may have special instructions on how to care for your results.
Surgery and Recovery
Tissue Expander Reconstruction surgeries are usually performed in a hospital and require an overnight stay. Depending on the extent of the procedure, local or general anesthetic may be used at the discretion of your plastic surgeon and within the boundaries of your discussed preferences. During surgery, a small incision is made in the breast muscle to house the expander device. If performed concurrently with a mastectomy, the procedure will take considerably longer and will be more complex. However, it will negate the need to schedule a second surgery during which to place the expander.
Recovery from this operation usually takes roughly four weeks, and—especially if paired with a mastectomy—can involve several days in the hospital afterward, though usually this is limited to only an overnight stay. You will need to schedule a follow up appointment every few weeks to inject more saline into the device, and you may experience a “tugging” sensation as the expander performs that basic function. Once the expansion phase is complete, you will need to schedule another operation to remove the tissue expander device and place a more permanent breast implant.