A tissue expander is like an un-inflated balloon made of silastic. The device is placed under the skin of the breast/chest wall. It is usually placed behind the chest muscle (pectoralis major) but sometimes it is placed in front of the muscle directly under the skin. This procedure is done whilst you are asleep under a general anaesthetic. The stitches are usually dissolvable and do not need to be removed.
The expander will be progressively inflated at regular intervals with saline (sterile salt water) through the port using a needle. The ports are located under the skin. There are two types of expander; one has an integral port within the structure of the expander which is located using a magnet. The other has a remote injection port connected with tubing under the skin usually along the crease of the breast line. The expander with the remote injection port can generally be left in place after expansion is complete as it also functions as a long-term breast implant – the port and its tubing will be removed during a second procedure. An integral port expander will need exchanging on completion of expansion for a permanent implant or flap reconstruction.
When the expander has been inflated sufficiently it is usually left for a period of time to allow the stretched skin to settle. You may have further surgery to either remove the port, exchange the expander for a permanent implant or exchange with an autologous flap (using own tissue from another part of your body). The surgeon will discuss this with you in detail when you decide which definitive method of reconstruction suits you and your lifestyle best.
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