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Saint Louis Breast Reconstruction: Tissue Expander

What is tissue expander breast reconstruction? When a mastectomy is required to treat breast cancer, the breast is removed, resulting in a deficit of breast and skin tissues. The missing breast tissue and skin can either be replaced with other tissues from the patient using a flap operation, or the skin stretched with a tissue expander and the volume replaced with a breast implant.

A tissue expander is a temporary breast implant device that is placed under the pectoral muscle of the chest and inflated over time to stretch out remaining muscle and skin. A material known as an acellular dermal matrix or AlloDerm® is placed to support and pad the bottom of the breast. In suitable candidates, the tissue expander is later replaced with an implant. Alternatively, the patient’s own tissues can be used later as a flap to help build a new breast. This is particularly true if radiation therapy is a part of the cancer treatment plan.




Reconstructive timeline with tissue expanders:

  •  First operation: Mastectomy + Tissue expander/AlloDerm® breast reconstruction(s)
  • Office visits: Drain removal and wound checks, fill tissue expander(s)
  • 4 months*: Exchange tissue expander with permanent implants; possible balancing procedure on other side. Possible fat grafts to optimize breast contours.
  • 7 months: Nipple reconstruction. Possible fat grafts to optimize breast contours.
  • 9 months: Areola reconstruction with tattoo
  • 12 -24 months: Laser or IPL scar therapy .

* If chemotherapy is required, tissue expanders are usually exchanged 8 months later. If radiation therapy is also required, tissue expanders are replaced with implants or the patient’s own tissues (flap) at least 12 months later. The remaining procedures follow, in sequence thereafter.










Anesthesia: Tissue expander breast reconstruction is performed with the patient under general anesthesia.

Length of procedure: 60 minutes for one breast, 90 minutes for both breasts.

Estimated recovery time: Hospitalization is usually 1 to 2 days. You can return to work after 2 to 4 weeks and should avoid vigorous activities for 6 weeks. Visible bruising and swelling should begin to improve within 3 weeks. To learn how to prepare for a tissue expander breast reconstruction and what to expect afterwards, click here to download our patient instructions.

Side effects: Common side effects include bruising and swelling. The breast may appear deflated, misshapen and irregular immediately after surgery. This should improve as the tissue expander is progressively inflated. The tissue expander is less soft than the permanent implant that eventually replaces it. Delayed wound healing and infections may occur. Click here to download a detailed consent form from the American Society of Plastic Surgeons that lists the risks and benefits of a tissue expander breast reconstruction.

Before-and-after photos of breast reconstructions with tissue expanders and implants: Click here 

If you have questions or would like to book a consultation with one of the surgeons at West County plastic Surgery, please call (314) 996-8800

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Meet Our Surgeons

There’s something different about West County Plastic Surgeons of Washington University. Not only do our surgeons provide an accessible and patient-friendly atmosphere, but we uphold Washington University’s reputation for cutting-edge procedures. We invite you to learn more about our surgeons.
Dr. Terry Myckatyn

Voted among the "Best Doctors in St. Louis" and "Best Doctors in America" by Best Doctors, Inc. since 2008, Dr. Terry Myckatyn is no stranger to being recognized for his work in plastic surgery. A board-certified plastic and reconstructive surgeon in the United States and Canada, Dr. Myckatyn specializes in all forms of cosmetic surgery and breast reconstruction. Read On

Dr. Marissa Tenenbaum

Dr. Tenenbaum – a board-certified plastic surgeon – specializes in all forms of cosmetic surgery and breast reconstruction, employing techniques acquired through working with some of the most respected cosmetic and reconstructive surgeons in the country. She has been voted among the "Best Plastic Surgeons" and "Best Doctors in America" by St. Louis Magazine. Read On

Emily Weinhaus P.A.

A licensed physician’s assistant, Emily performs non-invasive cosmetic procedures, such as BOTOX® injections, fillers, laser skin resurfacing, laser hair removal and spider vein treatments. Read On