Tissue Expander for Staged Breast Reconstruction

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If the best option for you is a staged reconstruction,
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you will most likely receive a temporary tissue expander
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at the time of your mastectomy.
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During mastectomy, the surgeon creates a pocket,
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generally behind the chest muscle where a temporary tissue
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expander may be placed.
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At the time of surgery,
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the surgeon will insert small surgical drains for
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your body's natural healing fluid.
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Through a port located inside the expander,
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the team will periodically inject saltwater solution
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to fill the expander over a few months.
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The expander gradually stretches the muscle and
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skin in preparation for
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either an implant or tissue reconstruction.
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After the skin over the breast area has stretched
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to the appropriate size,
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the expander will be removed in a second operation and
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the final reconstruction will be performed.
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Most often, we place a sheet of collagen,
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a material that is natural in your body as reinforcement for
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the tissue expander.
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This is called an acellular dermal collagen matrix in which
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blood vessels grow in over time becoming a part of you.
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This provides an internal bra of sorts or a sling to support your
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reconstruction by preserving the fold under the breast.
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The whole process can take weeks to months and is different for
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each individual, depending on whether treatment such as
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chemotherapy or radiation therapy are required.
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The tissue expander is always temporary,
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hospitalization is usually overnight.
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And women are usually back to work within two to four weeks,
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depending on the type of job.
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There is some discomfort with the expansion process,
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because it is stretching the chest muscle,
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but most women find that it is most sore in the first couple
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of weeks improving over time and is overall very well tolerated.
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The drains will remain in for one to two weeks.
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At Johns Hopkins,
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your experienced breast reconstruction team will do
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everything possible to make your breasts look and feel as natural
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as possible and will be able to answer any of the questions or
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concerns at any time throughout your treatment.