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Tissue Expanders

Also known as Non-Autologous Breast Reconstruction.

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Breast reconstruction with tissue expanders is one method used to rebuild a woman’s breast following a mastectomy.

The goal of breast reconstruction is to match the affected breast as closely as possible in shape and size to the natural breast. In the case of bilateral reconstruction (both breasts), this procedure allows for greater flexibility in size, selection and symmetry. Dr. Van Laeken will help you determine if this is an appropriate procedure for you. She will review the surgical techniques and share with you, before and after photos at the time of your consultation.

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This procedure can be done either at the time of the mastectomy (immediate reconstruction) or later (delayed reconstruction).

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Breast reconstruction makes many women feel better about their appearance, however, it is important, to be realistic about the expected outcomes. A reconstructed breast won’t look exactly like your original breast nor will the sensation be similar.

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This procedure can take up to one year to fully complete and requires three operative procedures.

Who is a candidate?

  • ​Patients who have had a mastectomy (Note: Not an option for patients who have had a radical mastectomy. This was an operation done many years ago whereby the chest muscle (pectoralis) was removed. It is rarely performed today).

  • Healthy women not requiring radiation. For those who do need radiation, the recommendation to proceed with this type of reconstruction will be decided on an individual basis).

  • Thin women with very little body fat are not candidates for a tram procedure and therefore, may opt for breast reconstruction with tissue expanders and later breast implants.

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Preparation for surgery

It is very important that Dr. Van Laeken is aware of the state of your general health prior to surgery. Please let her know of any allergies you have, medications, herbal supplements, or vitamins you are taking as well as the reasons for taking them. It is also important that you inform Dr. Van Laeken if you have a tendency for keloid scarring (thick, wide, or raised scars).

 

Prior to tissue expander surgery, you will undergo a comprehensive pre-operative assessment. Depending on your age as well as your general health, pre-operative testing such as a blood test, an ECG, or a mammogram may be required.

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If you are a smoker, we encourage you to abstain from smoking before your surgery for at least 14 days. Smoking can interfere with the blood flow to the skin, and will inhibit the healing of the incisions.​​

Procedure

Dr. Van Laeken operates at several different hospitals, but generally performs breast reconstruction surgeries at Mt. St. Joseph's and St. Paul's Hospital. These are both state of the art, fully accredited private surgical facilities.

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The tissue expander procedure typically involves an incision around the perimeter of the chest. Underneath the skin, a pocket is created, and the tissue expander is placed. Initially, the expander is inflated gradually to stretch the surrounding chest tissue. This process is repeated over several weeks, slowly increasing the size of the expander and reshaping the breast form. Once the desired volume is achieved, a silicone implant is inserted over the expander, permanently creating the final breast shape.

Recovery

The initial recovery period following tissue expander surgery involves some discomfort and the need for continuous compression. You'll be instructed to wear a supportive bra 24/7 for several weeks. You’ll experience swelling and bruising, which gradually subside over time. The tissue expander will be inflated over several months to shape the breast. The final silicone implant will be removed in a subsequent procedure, typically 6-9 months after the initial surgery.

Potential Complications

There are risks associated with any type of surgery. Although the incidence of complications is rare, Dr. Van Laeken feels that all patients should be informed of the potential complications prior to proceeding with surgery. Saline implants carry many of the risks as silicone gel-filled implants, including capsular contracture, infection, pain, and nerve damage. Implants, whether filled with saline or silicone, are not a lifetime device and may need to be replaced.

Anesthetic Issues

Adverse reactions to local or regional anesthesia, ranging from mild discomfort and itching to more severe complications such as allergic reactions, nerve damage, or hypotension.

Bleeding

The escape of blood from blood vessels, resulting in hematoma formation or external hemorrhage.

Capsular Contracture

The most common problem with breast augmentation occurs when the scar tissue or capsule around the implant contracts. Capsular contracture can cause the breast to feel hard, and may distort the shape of the implant. This problem is associated with a hardened capsule, and does not mean that the implant was placed improperly at surgery. Vigorous massaging may help alleviate some of the contracture, however, in severe cases revision surgery is required to remove the scar tissue, and sometimes it is necessary to replace the implant.Symptoms of capsular contracture range from mild firmness and mild discomfort to severe pain, distorted shape of the implant, and palpability (ability to feel the implant). Capsular contracture is graded into 4 levels depending on its severity. Baker Grades III or IV are considered severe and often additional surgery is needed to correct these grades:

Baker Grade I: The breast is normally soft and looks natural
Baker Grade II: The breast is a little firm but looks normal
Baker Grade III: The breast is firm and looks abnormal
Baker Grade IV: The breast is hard, painful and looks abnormal

DVT / PE

Abbreviations of Deep Vein Thrombosis and Pulmonary Embolism. DVT is a blood clot in a deep vein, typically in the leg. PE is a potentially life-threatening condition where a DVT breaks loose and travels to the lungs, obstructing blood flow.

Implant Displacement

Movement of the implant from its intended position, potentially affecting its functionality or causing discomfort.

Implant Rupture

Failure of the implant material to maintain structural integrity, leading to leakage of the filling material or a loss of mechanical support.

Keloid Scarring

Keloid scars are thick, wide, or raised scars.

Contact us

To find out more or to book your consultation.

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