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Breast Reconstruction FAQs: Breast Implants and Tissue Expanders

By PJ Hamel

With Breast Cancer Comics by Dash Shaw 

Published Wednesday, May 30, 2007

Breast Tissue Expander

Q. What exactly happens during breast reconstruction surgery?

A. There are two methods a surgeon may use to build an implant. First, he or she may simply place the implant behind the chest muscle (or, less commonly, in front of the chest muscle) after having removed your breast tissue, and close up the skin. This works best for small-breasted women; or for women who are having a bilateral mastectomy, and are happy with small breasts post-implant. Second, the surgeon may remove your breast tissue, then place an expander–a hollow sack–behind (or in front of) your chest muscle, and close up the skin.

This expander is equipped with a valve, through which saline can be pumped. Over the course of several months, more and more saline is pumped into the sack, gradually stretching your skin. When the skin has been stretched enough to accept the size implant you want–generally, the size that comes closest to matching your other breast–the sack is removed, and the permanent implant put in its place. 

This method works well for larger-breasted women. Its disadvantage lies in the fact that it can be a fairly uncomfortable process, and it involves additional surgery (to replace the expander with the implant). So, are you a candidate for an expander, or would you do fine with just a one-step implant? Don‘t worry, your surgeon will take a good, hard look at your body and make a recommendation. (Be aware that some surgeons believe ALL women want larger breasts, and automatically suggest going the expander route. If you’re fine with small breasts, insist on foregoing the expander, no matter what the surgeon says!)


Next, Reconstruction FAQs: Saline vs. Silicone Breast Implants 

Also, Breast Cancer Comics: Implant Complications

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