What You Need To Know About Tissue Expanders

Researching breast reconstruction online can be tough, and finding info. on tissue expanders can be even more difficult. Most of the information out there comes from very personal stories from women with breast cancer  (which are awesome, but they’re also super specific to that woman), jargon-laden medical research (the latest studies are great, but they beg questions about the subject size, funding, etc.) or materials from makers of surgical products (as helpful as these can be, they were created as marketing tools). But tissue expanders aren’t as complicated as they might seem.

What are tissue expanders?

If you think tissue expanders expand breast tissue post-mastectomy surgery you are right. Once the breast tissue and fat is removed, tissue expanders (made of silicone) are inserted if you are opting to have breast implants for your reconstruction. It pretty much looks like a deflated breast implant.

During recovery time, the tissue expander is injected with saline to gradually expand the healing breast tissue to the desired reconstructed size. Then an implant or tissue from another part of the body will replace it. This is why it’s called a two-stage reconstruction. Inserting the tissue expander can take between one to two hours of surgery time.

What’s involved? How long will it take to recover?

Tissue expanders can also be inserted immediately after a mastectomy or later. The surgery is typically performed by a plastic surgeon. Recovery can be anytime between four to eight weeks. During that time, your surgeon will inject saline into the tissue expanders.

You may find you’ll actually feel the chest stretching and some find the process uncomfortable. The good news is that research shows that tissue expander surgeries have a low rate of complications (6.5 per cent), and is not likely to interfere with cancer treatment, like radiation.

How much will it cost me?

Thankfully nothing. Post-mastectomy breast reconstruction, including the use of tissue expanders, are covered in Canada under all provincial health plans.

Do both breasts need to be removed to use tissue expanders?

No. Tissue expanders can be used for single and double mastectomies.

Any downsides to tissue expanders?

Well, time for one. Because it’s a longer procedure, there are more hospital visits, including the initial surgery, injections and another surgery to replace the tissue expanders. (That said, permanent implants aren’t exactly “permanent,” as they may have to be replaced after 10 to 20 years.)

Although rare, there are warnings that the saline valve could leak, the tissue expander may move or slip in the chest, or that scar tissue can impact the expander.

The other downside is the discomfort that some women feel while the tissue is expanding, which is described as tightening in the chest. This can cause sensitivity to heat or cold, and sometimes difficulty in finding a comfy sleep position. Pillows can be your best friend to help prop you up and make you more comfortable!

Why are tissue expanders the best choice for some women?

Tissue expanders are the best choice post-mastectomy when an implant will be used in order to stretch the skin around the breast and chest wall muscles when the skin is taught. Women who have a small frame are also less likely to be a candidate for fat grafting surgeries that require excess body fat.

Are tissue expanders your only option?

Not at all. Breast reconstruction has evolved and so have women’s options, including tissue reconstruction, to forgoing reconstruction. But you will want to set up a plan with your physician that best works for you, from recovery and pain management to planning the surgeries. For more information on reconstruction, click here or here.  – Lisa Hannam

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