Tissue expansion is accomplished under a general anaesthetic by the placement of a “tissue expander” beneath the muscle of the chest wall. Expanders initially resemble a flat balloon. During visits to the clinic over the next four to six weeks, sterile saline is injected into the expander to stretch the surrounding tissue to the point where it will accept the proper size implant. There is some discomfort with each expansion but the patient can usually continue normal activity. Removal of the expander and placement of the final permanent implant is done during a second anaesthetic. Some types of expander can stay in permanently.
Patients with radiated skin or excessively thin skin are not usually candidates for tissue expansion, as the tissues will not stretch.
Complications are unusual, but can include breakdown of the tissue during expansion, infections, bleeding, asymmetry and firmness of the reconstructed breast.
Here a silicone breast expander is placed underneath the muscles in the chest in a deflated state. After the scar has healed saline can be injected via a small needle into a self sealing port away from the implant and allow it to be expanded in clinic over time to recreate the breast.
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