Breast Expanders in Breast Reconstruction: What You Need to Know

When women go through a mastectomy, breast reconstruction is often a choice that goes with that surgery to improve cosmetic output post-op. However, there are cases where after the mastectomy, the doctor will insert the breast expander to facilitate the skin shape formation in preparation for a permanent implant. A breast expander is a temporary implant used to stretch the skin and tissue of the breast. The permanent implant will take over the breast expander when the time is right for its replacement.

Breast Expanders for Delayed Breast Reconstruction

The breast expander is also particularly helpful in cases of delayed breast reconstruction. Some mastectomy patients still need to go through a treatment process such as radiation therapy and that usually means holding off any breast reconstruction surgeries until the treatment is complete. When there is delay there is a possibility of the skin no longer having enough area to hold a breast implant when the reconstruction surgery is requested. Breast expanders gradually stretch the skin over a course of time so that it will be enough to support the new implant.

Breast Expander Placement

Submuscular / Under the Muscle: The expander is placed underneath the pectoralis major muscle. This is the large muscle that covers the chest. This placement is quite common for women who have larger size breasts or who prefer a more natural-looking result. 

Prepectoral / Over the Muscle: The expander is placed on top of the pectoralis major muscle. This is a placement that is more common for women who have smaller breasts or who prefer to have their reconstruction surgery sooner after their mastectomy. 

Gradual Growth and Management

Over the course of weeks or months, the patient is required to have regular visits to the doctor’s office. An inspection is done as well as gradual increase of fluid addition into the expander to facilitate growth of skin tissue. The amount of fluid added each time will depend on how much the patient’s skin and tissue can tolerate. It is important therefore to communicate clearly with your doctor how you feel during the expansion process and try to be transparent about any discomfort that you feel along the way. Though mild discomfort may be normal but if it becomes too painful, you need to inform your doctor.

After achieving the desired size of the breast, the expander is surgically removed and in its place the permanent breast implant. Normally this is a surgery that is done as an outpatient procedure so you don’t need to stay much longer than needed unless indicated otherwise.

Breast Expander Risks

Breast expanders, primarily, are not naturally a part of your body so you have to remember close monitoring and regular visits to your doctor will help you watch out for any complications that may arise during the process. There is risk of bleeding, fluid leakage, infection, and capsular contracture (hardening of the scar tissue around the expander). Rest and a healthy diet will greatly help in the expansion process. You will want to avoid activities that may cause blunt trauma or exacerbate the scarring on the surgery site. 

After your breast implant surgery, there are ways to manage your scar formation on your skin so that it will not be as conspicuous when just left on its own. Many women have gone through the whole procedure from mastectomy to breast reconstruction. Most of the feedback has been rather positive while other women have opted to simply have their breasts flat post-op. Ultimately it is a choice for you if you prefer to use breast prosthesis or having an implant depending on which one fits more for your lifestyle and comfort.

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