Expander to Implant

Expander to implant reconstruction involves a two-stage approach. The first surgery involves placing a tissue expander (a temporary implant which can be filled with salt water) under the pectoralis muscle of the chest and covering it with the remaining breast skin. This can be done immediately (at the time of the mastectomy) or in a delayed fashion. The purpose of the tissue expander is to stretch the tissue and skin of the chest so that it can eventually accommodate the final breast implant. The expander is filled quite a bit during the initial surgery, leaving the patient with a breast mound when she wakes from surgery. Following the surgery, the expander is filled with more salt water on a weekly basis, until the surgeon and patient are happy with the size of the breast. The final surgery is performed two to three months after the last expander fill. It involves exchanging the expander for the final implant, thus creating a more natural breast shape. Nipple reconstruction and fat injection can also be performed during the second stage. Each surgery takes approximately one hour and can be performed as a day surgery. Some patients, however, choose to remain overnight. Full recovery takes 3-4 weeks.