Tissue Expanders in Breast Reconstruction

Have you ever wondered how tissue expanders work in breast reconstruction?

When breast tissue is removed during a mastectomy, a lot of blood vessels are also removed. This greatly reduces the amount of blood flow to the remaining skin and tissues. The remaining blood vessels are usually very small, and it takes time for the body to adjust and create new circulation to the area.

Swelling can also affect the blood supply after a mastectomy. When there is swelling present around these small blood vessels, it is easy for those tiny vessels to become compressed and reduce blood flow even further.

If you also add an implant to the area, that can put even more pressure and compression onto those remaining blood vessels. If circulation is impaired or reduced too much, the skin and the incision will not receive enough oxygenated blood. Our skin and tissues need oxygenated blood in order to heal and recover. If areas of the skin on the breast don’t get enough blood supply, the skin can become necrotic (die) and become infected.

Tissue expanders help to allow the body time to recover from surgery, create new circulation, and time for the swelling to go down. Tissue expanders are filled slowly over time with saline, which then allows the skin and tissues to stretch gradually over time to make room for an implant. Saline is injected into a port on the tissue expander through your skin using a syringe and a needle. Expanders are usually filled gradually weekly or biweekly over the course of several months, until the desired size and shape are achieved. Then, another surgery is done to swap the tissue expanders for implants.

Tissue expanders are very common and safe. There is still a risk for infection after surgery, the same as with an implant. You can still get chemo and radiation with a tissue expander in place. Tissue expanders have metal in them as part of the access port and are more firm than an implant. Expanders feel very different than an implant will. If you have expanders, know that your implant will be softer and feel more natural. You can feel sore for a few days after your expander is filled as your skin stretches to accommodate the increase in size. Typically this pain is mild and can be managed with over-the-counter medications.

For more detailed information about expanders, please visit Tissue Expanders and Breast Reconstruction