Breast Reconstruction with Tissue Expanders/Implants (The James)

Breast Reconstruction with Tissue Expanders/Implants (The James)

 

The goal of any breast reconstruction surgery is to help you feel comfortable with the shape of your breasts in clothing. The shape and size of your breasts before surgery will determine the placement of the tissue expander and the final shape of your reconstructed breasts. Tissue expander breast reconstruction is not able to create an exact copy of your removed breasts. In order for your breasts to be similar in size and shape, your surgeon may offer you a procedure on the other breast such as a lift, reduction or augmentation. This surgery can be done during your breast mastectomy surgery to remove your cancer or after your chemotherapy or radiation treatment is complete.

Breast reconstruction with tissue expansion and implants may be a 1 or 2-step process. Your doctor will talk with you about what option is best for you. The first step uses a silicone balloon-like device called a tissue expander. This is put under your skin and chest muscle. Your tissue expander will be filled with sterile salt water (saline) over time, at frequent (probably weekly) visits with a nurse. To fill your expander, the nurse will use a magnet to find the small port that is on your expander under your skin. When the port is found, the nurse will clean your skin and then put a needle attached to a syringe filled with saline into the port. You will not feel this at all. The nurse will then inject the saline into the port to enlarge the tissue expander. It may take 1 to 4 months to fill your tissue expander to the size that is right for you. This process lets the tissues of your chest  stretch over the expander to create the shape of a breast. Once the expansion is done, the filled expander is left in place for 2 to 3 months. This lets the tissues become permanently stretched and makes the pocket where your breast implant will be placed. After your skin has been stretched enough, the expander is surgically removed and replaced with a permanent breast implant.

 

How long will the surgery take?

This surgery will take about 2 hours. This does not include the time it will take for any other surgery you may need, such as a mastectomy.

When tissue expanders are used, you will need to have a second surgery to remove the expander and replace it with a breast implant.

 

How long will I be in the hospital?

You will stay in the hospital overnight after your tissue expander surgery. The surgery to remove your tissue expander and replace it with a permanent implant is normally done as an outpatient procedure and you will go home the same day.

 

Where will my scar be?

Your plastic surgeon will use the same incision (cut) used for your mastectomy.

 

What are the benefits of this type of surgery?

Since your mastectomy incision (cut) is used again to put in the tissue expander and implant, there are no other scars on your body. When compared to the other types of breast reconstruction, this one has the shortest surgery time and the shortest recovery time.

 

What are the risks?

The most common risks with breast reconstruction with tissue expanders and implants include:

  • Short-term risks
    • Infection - If the skin on your reconstructed breast becomes infected, surgery may be needed to remove the skin or implant. If this happens, the   breast reconstruction process can start again after you have healed from the surgery.
    • Fluid build-up
    • Bleeding
    • Slow healing - this can increase your risk of infection.
  • Long-term risks
    • Capsular contracture - scar tissue that tightens around the implant and causes the breast to change shape and become hard.
    • Asymmetry - the size, shape or level of your breasts look uneven.
    • Malposition - the breast implant is not in the correct position.
    • Breast Implant-Associated Anaplastic Large Cell Lymphoma (ALCL) - a rare type of cancer that can happen with breast implants.

 

What type of support will I need at home?

  • You will need to have a family member or friend drive you home after your surgery and hospital stay. They should stay with you at least 24 hours after you are home to make sure you are recovering well.
  • After your surgery, you will not be able to lift, push or pull anything over 3 pounds. You will need help doing laundry, cooking and other housework.
  • You need to wait until your drains are removed and your doctor says it is okay for you to drive. You will also not be able to drive while you are taking opioid pain medicines.

 

 

© June 10, 2022. The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute.

This handout is for informational purposes only. Talk with your doctor or health care team if you have any questions about your care.