You will have compression sleeves on your legs that help with circulation. Tissue expansion is a common technique used for breast reconstruction. The most common method of breast reconstruction currently performed in the us uses tissue expanders and breast implants, usually with an adm acellular dermal matrix such as alloderm. Tissue expanders are breast implants that can be inflated while they are in your chest.
When i was originally shown the expander it looked like a small, almost. The tissue expander will be expanded in multiple sessions to allow a gradual stretching of the patients muscle and skin. B port c catheter d syringe e ribs f pectoralis major muscle. Subcutaneous tissue expander placement with synthetic. The first phase of breast reconstruction using tissue expanders is this stretching of the skin expansion. Most agree that the expanders do need to be in place for somewhere between 36 months before being removed for the second stage procedure to place permanent implants. Feb 04, 2020 a metaanalysis of human acellular dermis and submuscular tissue expander breast reconstruction. How tissue expanders are used in breast reconstruction. Some women dont need tissue expansion and can have an implant saline. What is a typical timeframe to keep in tissue expanders. A tissue expander is an empty breast implant that your surgeon will fill with normal saline over 6 to 8 weeks until it reaches the breast size that you and. Preoperative appointment for first stage reconstruction surgery. When back tissue is used for breast reconstruction, it involves the latissimus dorsi muscle, along with the skin and fat that covers the muscle.
Expanderimplant breast reconstruction guideline work group of the american society of plastic surgeons. Implant based reconstruction is a popular choice for breast reconstruction when a woman does not want to use her own tissue. Expanderimplant delayed breast reconstruction medscape. If you need transportation, lodging, child care or elder care, there may be programs that can help. Tissue expanderbreast reconstruction surgery timeline for breast reconstruction implant expander 1. Breast reconstruction with tissue expanders and implants. Research is looking at implant reconstruction with a tissue expander using a dermal matrix product to cover the implant compared to using skin and muscle to cover the implant. Typically requires a 3 day inpatient hospital stay.
This may be done immediately following the mastectomy, or as a delayed procedure. Tissue expander reconstruction mastectomy breast repair. We discuss your surgical plan and start the scheduling process. Tissue expansion is a process that stretches your remaining chest skin and soft tissues to make room for the breast implant. A novel tissue expander system offers new options in breast. Overfill of tissue expanders is a commonly used modality to achieve customized dimen. Prior to having breast cancer, i naively thought a bilateral mastectomy consisted of removing old boobs and putting in new permanent implants. In a clinical trial, tissue expansion with the aeroform for all sizes took an average of 21 days as compared to 46 days for saline expanders.
The expansion timeline depends on the condition of your breast skin and how often you trigger a release of carbon dioxide. A tissue expander is a temporary device that is placed on the chest wall deep to the pectoralis major muscle. This essentially involves expansion of the breast skin and muscle using a temporary tissue expander. Breast reconstruction using a tissue expander memorial sloan. The premature removal of tissue expanders in breast reconstruction. Exercises after breast reconstruction using implants breast cancer. The tissue expansion actually creates new skin for us to work with if necessary. Breast cancer reconstruction and expander infection. Immediate breast reconstruction with tissue expander. Implant based reconstruction should be performed immediately at the time of mastectomy. See the exercises to do after breast reconstruction surgery using a simple implant or a tissue expander implant. Once in place, the expander is gradually filled over time.
Implants may require removal or replacement at some time in the future. Mar 10, 2011 a presentation in our plastic surgery society indicates this puts patients who undergo breast reconstruction at a higher risk for infection, reoperation, and consequently, reconstructive failure. Before the procedure, temporary tissue expanders implantable, expandable, balloonlike devices used to stretch breast skin and chest wall muscles over several monthsare used so that the breast implants can be adequately accommodated. The reconstruction process takes 6 months to one year, no matter what procedures are chosen, and if no further cancer treatment is necessary. Irradiation after immediate tissue expanderimplant breast reconstruction. Living with breast tissue expanders after reconstruction. Tissue expander reconstruction surgeries are usually performed in a hospital and require an overnight stay. Women who have had breast reconstruction may be instructed to limit their range of motion when beginning these exercises. During the first stage of reconstruction, when the tissue expander is placed, most patients take a minimum of several weeks off of work. Breast reconstruction timeline prma plastic surgery. Post mastectomy reconstruction with a tissue expander and implant involves a staged approach. After implantation, the aeroform tissue expander uses controlled carbon dioxide inflation operated by patients in preparation for a permanent implant and breast reconstruction. Implant based surgery tissue expanders, directtoimplant with alloderm typically requires a 1 day stay in the hospital. The patient was seen for followup 6 months later, after completing a staged right breast reconstruction with tissue expander to implant, nac reconstruction, and a left breast symmetry procedure.
The purpose of a tissue expander is to stretch your skin to prepare it for an actual breast implant. If performed concurrently with a mastectomy, as the procedure will take considerably longer and will be more complex. You will be on pain medication, and usually have two drains for each breast that are under your skin and exit from your underarms. Aug 29, 2019 during implant reconstruction, if youre having the implant inserted at the same time as mastectomy immediate reconstruction and enough tissue is available to cover the implant, your plastic surgeon will place the breast implant either under the chest muscle or over the chest muscle after your breast surgeon has removed the breast tissue. Breast implants implants are placed in a womans chest under the skin, fat, and muscle. We obtain your history and discuss reconstructive options. This is usually performed as a multiplestep procedure starting with tissue expanders. The first stage is inserting the tissue expander either above or under the pectoral muscle chest muscle. Another recent advancement in tissue expander breast reconstruction is the use of. Scope these guidelines specifically address the risk factors, treatment, anticipated outcomes, and followup of patients undergoing breast reconstruction with expandersimplants for the treatment of cancerous defects. Surgeons work off the timeline they feel most comfortable. After your breast surgeon performs the mastectomy, your plastic surgeon from the institute of reconstructive surgery begins your. Breast reconstruction faqs md anderson cancer center.
During surgery, a small incision is made in the breast muscle to house the expander device. A silicone balloon expander is inserted beneath the skin. Tissue expanders recovery patients who undergo tissue expander surgery normally have several surgeries to complete their reconstruction. First stage placement of expander can be at time of mastectomy or afterwards 2. Achieving new dimensions of customization in breast reconstruction. Breast reconstruction using a tissue expander memorial. Drain instructions timeline for breast reconstruction how to. The first stage involves the temporary placement of a tissue. All patients undergoing breast reconstruction using tissue expanders at the authors institution in the 5 years before the protocol, and in the 2 years after, were analyzed. This is a preliminary series of 2stage breast reconstructions by means of tissue expander placed subcutaneously with the support of a titaniumcoated polypropylene mesh. Apr 08, 2014 this video describes tissue expander reconstruction in detail. Breast reconstruction and the pain in the ass known as.
Tissue expander to implant breast reconstruction prma. First surgery after the mastectomy has been completed, the reconstructive surgeon and his assistant prepare for immediate tissue expander placement. During the different stages of your breast reconstruction, your bra can be padded to help balance your appearance. Tissue expansion procedure steps american society of.
After the breast surgeon removes the breast tissue called a mastectomy, the breast surgeon or plastic surgeon performing the reconstruction will often put a tissue expander underneath the pectoral muscle. Expansion is also used to repair skin on the head and neck, hands, arms and legs. Women who choose to have their breast or breasts reconstructed after a mastectomy have several options, including breast implant surgery. Weekly visits for percutaneous expansion in the office68 weeks 3. The purpose of the expander is to create a soft pocket to contain the permanent implant. Both stages of teimplantbased reconstruction can be performed as a oneday surgery procedure. A comparison of dermal autograft and acellular dermal matrix in tissue expander breast reconstruction. When the tissue has grown to the desired amount, the expander is removed. Used in breast reconstruction, mentor cpx4 breast tissue expander.
Tissue expander reconstruction is a good procedure for most people. Denk points out that, in general, any woman who is a candidate for tissue expander reconstruction, whether immediate or delayed, is a candidate for the aeroform tissue expander. Breast reconstruction may be done at the same time as a mastectomy or in a separate surgery. Breast reconstruction with implants and expanders what you. Cpx4 breast tissue expanders maintain key features fundamental to the. This appointment will be scheduled for the same day as your first appointment with the doctor.
At the same time your mastectomy is done by our breast surgical oncologist, the breast plastic and reconstructive surgeon will insert a tissue expander beneath your skin and chest muscle. The tissue from your back is removed and moved to the front of your chest, with the arteries and veins still attached. Expander the expander is basically and implant with nothing in it. Breast reconstruction can help restore the look and feel of the breast after. Continuing these exercises after you regain full range of motion will help to prevent scar tissue from forming in your armpit and shoulder. This procedure is called a latissimus dorsi ld flap. Tissue expander breast reconstruction study on breast volume. The tissue expander will be replaced with a permanent prosthesis in 36 months. During my decisionmaking process of whether or not to have a preventive double mastectomy based on my family history of breast. Breast reconstruction with a tissue expander and implant usually involves at least three stages. Feb 03, 2020 breast reconstruction is surgery to rebuild one or both breasts with implants. A tissue expander is a temporary, waterfilled implant that acts as a spacer to prevent contraction of the skin and maintain the shape of the breast.
After mastectomy and tissue expander reconstruction, you may wake up feeling groggy as you awaken from the anesthesia. With delayed breast reconstruction, the surgery is done at. Breast reconstruction with implants and tissue expanders. Halvorson, md, for unc in chapel hill reports the use of one dose of perioperative prophylactic antibiotics was associated with a 4fold. In certain select cases, implant breast reconstruction can be performed in. Alternative treatments would consist of the use of external breast prostheses or padding, breast reconstruction without tissue expansion, or the transfer of other body tissues for breast reconstruction. The timeline for completing breast reconstruction varies, depending on how many surgeries are done and the need for other cancer treatments. What is a typical timeframe to keep in tissue expanders after. Your surgeon will increase this limit after your first followup visit. Longterm aesthetic outcomes and capsular contracture. Dec 20, 2017 because fewer than 20% of the women elect to undergo immediate reconstruction after mastectomy, many survivors are candidates for delayed breast reconstruction. Take team approach to breast cancer treatment duration. Breast reconstruction or prosthesis after mastectomy. Three hundred five patients underwent 456 tissue expander reconstructions in the 5 years before the protocol, and 198 patients underwent 3 reconstructions in.
A breast tissue expander is an inflatable breast implant designed to stretch the skin and muscle to make room for a future, more permanent implant. Tissue expansion is very much like pregnancy in that after pregnancy, most women find that they have new skin of their lower abdomen that they did not have before. When a patient has a mastectomy and desires reconstruction, the breast reconstruction is often done in stages. In breast reconstruction, a permanent implant is then inserted. Expanders are slowly filled with saline over 2 to 3 months. Timeline for breast reconstruction with tissue expanders. It does, however, involve another surgery to have the permanent implant placed. It is important to remember every breast reconstruction journey is different and depending on your individual experience, this timeline may vary. In certain select cases, implant breast reconstruction. Before the procedure, temporary tissue expandersimplantable, expandable, balloonlike devices used to stretch breast skin and chest wall muscles over several monthsare used so that the breast implants can be adequately accommodated.
There is no absolutely correct answer to your question. Health system customer programs healthy workforce hip fracture care program. This information will help you learn how to care for yourself after your breast reconstruction surgery using a tissue expander and will help you. My mastectomy permanently changed my ability to work out. Shareef jandali is a board certified plastic surgeon in connecticut. You may need to have a tissue expander, or balloon like sac, placed in each breast before an implant is placed. Tissue expander surgery involves decreased time in the operating room, decreased length of hospitalization, and decreased recovery.
The most common method of breast reconstruction currently performed in the us uses tissue expander and breast implants. Jan 07, 2016 a subcutaneous, prepectoral, musclesparing approach has been recently described for implantbased breast reconstruction. Many plastic surgeons differ somewhat on their tissue expander timeline for breast reconstruction. Novel tissue expander for breast reconstruction clears fda. About breast reconstruction using a tissue expander and implant after your mastectomy surgery to remove your breast, you will have a breast reconstruction surgery using a tissue expander. The dermal matrix essentially forms a sling that helps form a pocket and support the lower portion of the implant, holding it in position. During the second stage, the tissue expander is exchanged for permanent prosthesis with fat grafting to reconstruct the breast. Exercises after breast surgery with reconstruction using a. The anatomic tissue expander group had a higher proportion of women who underwent chemotherapy and radiation before 491 tissue expander implantation and a higher proportion of women who had both breasts reconstructed.
Breast reconstruction with tissue expanderprosthesis. Breast reconstruction with expanders andor implants breast. Right now i have tissue expanders first step in breast reconstruction that were placed inside my empty breast cavities. The breast is usually reshaped in two stages, or surgeries. Table 1 presents the study variables stratified by tissue expander type per woman, breast, and procedure. Breast reconstruction with tissue expander is an elective surgical operation. Nipple reconstruction will take place 23 months later. Cordeiro p g, pusic a l, disa j j, mccormick b, vanzee k j. Breast implant and tissue expander breast reconstruction.
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