Two-Stage Breast Reconstruction FAQs

What is the difference between a one-stage and two-stage breast reconstruction procedure?

A one-stage reconstruction procedure allows the plastic surgeon to place an implant at the same time the mastectomy is performed. Many women do not have adequate tissue remaining on the chest to allow for the implant, so a two-step procedure is used to expand the breast cavity.

Who is the ideal candidate for two-stage breast reconstruction?

Any woman who has lost a breast may find the two-stage breast reduction can be very successful at achieving their goals. The ideal candidate will be in generally good health, understand the breast reconstruction process, and have realistic expectations for her surgical results.

What is a tissue expander?

A breast tissue expander is an inflatable breast implant. The expander is placed after a mastectomy, and then slowly filled with saline solution, stretching the tissues to make room for a permanent implant.

How can a tissue expander assist in my breast reconstruction?

After your mastectomy, the skin and muscle that remain may not accommodate the placement of a breast implant. The tissue expander will slowly stretch this skin and muscle, allowing it to hold the desired size implant.

How is the tissue expander procedure performed?

The tissue expander may be placed during the mastectomy procedure, or it may be part of a delayed reconstruction process. By making a small incision within the breast tissue, Dr. Schwartz will be able to carefully place the unfilled expander. Once in place, dissolvable sutures will be used to close the incision. The expander will then be slowly filled with a salt-water solution, through a tiny port on the side of the breast. After the desired size breast pocket has been reached, the expander will be exchanged with a permanent breast implant.

What can I expect from the recovery period, after my tissue expander is placed?

Depending on the exact procedure performed, the recovery process after the placement of a tissue expander can take from two to four weeks.

Is the tissue expander painful?

While the tissue expander does not cause pain, there is mild discomfort each time it is filled. While patients report pressure or tightness in the breast area, these sensations will only last for a couple of days.

When can I return to normal activities, after my expander is filled?

Women are generally able to return to light activities and work the same afternoon as their expander is filled.

What are the potential risks associated with the tissue expander?

There are few risks associated with the tissue expander. As with any surgical procedure, issues such as infection, scarring, poor wound healing, and seroma (a fluid pocket) may occur.

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Jaime S. Schwartz, MD, FACS

Board Certified Plastic Surgeon