In 2008, according to the American Society of Plastic Surgery, approximately 80,000 women underwent breast reconstruction, most (80%) with expanders and implants. Implant reconstructions are done in 2 stages using a comaintain of tissue expanders and implants. The first step involves placement of tissue expander with a built-in port for filling under the chest wall muscle. This is typically done at the time of mastectomy. After 2-3 week of healing, the tissue expander is filled in the office by injecting saline through the built-in port. With a small amount of numbing medication this is a painless procedure. The amount of saline placed and the intervals are determined by your plastic surgeon at each visit. The fill volume can vary based on the amount of discomfort you experience during and after each expansion. When done properly, tissue expansion can be a relatively painless process with minimal discomfort. Depending on other adjuvant therapy for your cancer, tissue expansion can take anywhere from 3-6 months. After filling the expanders to a desired volume, they are removed and replaced with softer and more natural feeling implants. This requires a simple outpatient procedure with minimal recovery.
There are several advantages to this method of reconstruction. They include easier recovery, shorter operative time, and return to normal function in a relatively short time. This technique also allows the patient to have more control in determining their breast size. Some patients take advantage of this opportunity to either increase or decrease their natural breast size. With the recent improvements in implant design and selection, this option has become by far the most popular method of reconstruction.