This involves the placement of a tissue expander under the chest muscle. This can be accomplished immediately after the mastectomy is performed or at a later time. Once sutures are removed, saline is used to add volume to the expander over a series of office visits. These can be weekly or scheduled around a chemotherapy series. This stretches the skin as it expands. When expansion is adequate, the second stage of the reconstruction is scheduled where a permanent implant is inserted in place of the expander. Saline or silicone implants can be used. Nipple/areolar reconstruction can be started at that time if desired.
Advantages
Simplest surgery and shortest recovery from surgery. This is the favored procedure for persons who have heath problems or contraindications to extensive surgery.
Disadvantages
Multiple trips to the office over several weeks or months to undergo expansion. Capsule formation and, or lack of a natural breast “look” due to thin skin.
Possible Complications
- Loss of breast skin requiring removal of implant. If you have undergone radiation this procedure is not advisable as you are at increased risk for skin loss.
- Noticeable outlines of the implant due to capsule formation
- Hard texture due to capsule formation
- Thin breast skin
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