Breast tissue expanders are a common method used in breast reconstruction, particularly after a mastectomy. These temporary devices prepare the chest area for a permanent breast implant. Their primary function involves gradually stretching the skin and underlying muscle, creating a suitable space for the definitive implant.
Purpose of Breast Expanders
Breast expanders address the tissue deficit resulting from a mastectomy. They slowly enlarge the chest wall, encouraging skin and soft tissues to stretch and adapt. This creates an adequately sized pocket and a natural-looking contour for the permanent breast implant. The expansion accommodates individual healing patterns and ensures sufficient pliable tissue to cover the implant, contributing to the final appearance.
The Expansion Procedure
Filling breast expanders typically begins with surgical placement, often during the initial mastectomy. After surgical recovery, patients attend a series of office visits where a healthcare professional injects sterile saline solution into the expander through a magnetic port beneath the skin. These injections are administered incrementally, allowing tissues to stretch slowly. Patients may experience pressure or tightness during and after sessions, which usually subsides within a few days. The volume of saline added at each visit is carefully controlled, typically ranging from 30 to 120 cc, to ensure gradual tissue expansion.
Key Determinants of Filling Time
The duration required to fill breast expanders varies significantly, typically ranging from two to six months. Several factors influence this timeline.
Desired Volume and Tissue Characteristics
Desired breast volume is a primary determinant; larger implants necessitate more expansion and a longer filling period. Tissue elasticity and healing capabilities also play a role. Tissues that stretch more readily shorten the expansion phase, while less elastic tissues require more time.
Patient Comfort and Surgeon Protocol
Patient tolerance and comfort are considerations, as saline added at each session is adjusted based on discomfort or tightness. Pain or muscle spasms can affect the volume added per session and overall pace. The surgeon’s protocol and frequency of office visits also impact the timeline. Appointments are generally scheduled every one to two weeks, with the amount of saline determined by the surgeon.
Medical History
Pre-existing conditions or prior radiation therapy can significantly prolong the expansion phase. Radiation therapy can reduce tissue elasticity and increase the risk of complications like capsular contracture, potentially requiring a longer, more cautious expansion process or delaying the start of fills.
Transitioning to Permanent Implants
Once the breast expander reaches target volume and surrounding tissue has stretched, a resting period is often recommended. This period, typically four to twelve weeks, allows the newly expanded tissue to settle and soften. Following this phase, an exchange surgery is performed. During this surgery, the temporary expander is removed and replaced with the permanent breast implant. This marks the completion of the reconstructive process, establishing the final shape and size of the reconstructed breast.