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What To Expect from Breast Reconstruction Surgery and How A Tissue Expander Works

If you are undergoing surgery for breast reconstruction due to mastectomy, then your surgeon will be able to advise on the options available to you based on your body and circumstances.

Mrs Carla M Babicki  |  RGN

Last Updated On: May 6, 2023 | Published On: June 2, 2019


Medically reviewed by Mr Shivram Singh MBBS, FRCSI, FRCS (Plast), Medical Director & Lead,
Medical Advisory Committee for Manchester Private Hospital
Last Reviewed August 18th 2022

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For example, the amount of skin and tissue often determines whether you can have immediate reconstruction or whether it is advised that you wait for ‘delayed’ breast reconstruction.

When undergoing immediate breast reconstruction, an implant can usually be inserted straight away. This means that there is enough tissue and skin to accommodate the implant so that it looks natural in shape and size.

If during your mastectomy a large amount of skin and tissue were removed, or if you’re opting for delayed reconstruction through choice, then your surgeon will look to place an expander under your skin where the breast has been removed.

breast reconstruction

What Is An Expander?

A breast tissue expander is a type of implant, similar to a balloon, which is placed under the skin and on top of the chest muscle.

The expander stretches the skin over time to make room for the final breast implant.

An expander implant will start in a deflated state when it is inserted, and your surgeon will add fluid to increase its size. The fluid is usually salt water and will be increased over a period of six months.

This time period gives the skin enough time to stretch and accommodate the breast implant.

Mastectomy with insertion of an expander takes around four hours to complete.

If you wish to leave having the expander inserted until a later date, this is also possible but you should seek tailored advice from your surgeon regarding the condition of your skin and tissue.

Some patients still find it possible to have an expander inserted some years later. Although there is a chance that more healing and scarring will have taken place at the surgery site.

In order to stretch the skin further throughout the period of six months, your surgeon will inject saline solution in to the expander. During and after each injection patients sometimes report a feeling of pressure and some pain afterwards. This tends to subside within 24 hours.

Following the process of stretching the skin, you will then be able to have your final permanent implant inserted in place of the expander. This is performed around one and a half months after the last saline injection.

Replacing the expander with an implant can take around one to two hours.

If you are undergoing radiation therapy, then it is possible to still undergo with an expander in. In fact, some surgeons prefer it to be in place as it creates an opportunity to remove scarred tissue from radiation before final permanent implant placement.

However, each case is evaluated on an individual basis and speaking with your surgeon will allow for better judgement.

Furthermore, you will also be able to seek advice on recovery and aftercare.

After breast reconstruction surgery you will be given an aftercare plan that will help with recovering both physically and emotionally. Exercises are required to reduce stiffness and prevent the build up of too much scar tissue.

For patients who undergo mastectomy with implant placement you can expect to rest and take things easy for 6-8 weeks post operation. However, during this time you will still be advised to perform mild exercises to aid recovery.

For patients who are advised or opt for delayed reconstruction, it is often performed as an outpatient procedure and no overnight may be required. Recovery for delayed reconstruction can vary between 2-4 weeks.

If you have any questions or would like further information, call today on 0161 507 8822 and a friendly member of our team will speak with you in a calm and pressure-free manner. To know more about breast reconstruction surgery, please visit:

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