This video is for patients who have had reconstruction using a tissue expander. Here is an overview of the types of tissue expanders and implants used in breast reconstruction today. Get information from the american society of plastic surgeons about tissue expansion risks and safety. Breast cancer reconstruction and expander infection. I developed redness on the lower side of my breast. In the last four decades, most breast reconstruction that involved implants was done under the muscle. In some cases, the expander may need to be removed for several months until the infection clears. For me, the worst part of any of my surgeries was mentally getting geared up for it. How many ccs to put in expanders to achieve a large c cup.
Ariel rad, top breast cancer reconstruction surgeon in washington dc explains the benefits of breast expansion after mastectomy surgery. A tissue expander is a temporary breast implant device placed under the pectoral muscle of the chest and inflated over time to stretch out remaining muscle and skin. Allox2 tissue expander for breast reconstruction youtube. I did not have to have a drain put in because i had breast tissue he was placing the expander under so the trauma was minimal. Tissue expansion is a relatively straightforward procedure that enables the body to grow extra skin for use in reconstructing almost any part of the body. The use of alloderm lifecell, branchburg, new jersey, an acellular dermal matrix adm, in breast reconstruction to facilitate complete coverage of the implant expander gained popularity in 2005. Approximately four months after placement of the tissue expander, the device was removed and replaced with a permanent implant. Over the muscle versus under the muscle is the biggest debate.
Breast reconstruction with implants and tissue expanders. Kristine have you made your doctor aware of your constant pain. Prior to the development of tissue expanders, plastic surgeons had to resort to skin grafts and skin flaps to reconstruct damaged tissue. Breast reconstruction with tissue expanders and implants offers patients satisfying aesthetic results with no donor site morbidity. Breast reconstruction and the pain in the ass known as expanders. Tissue expanders the surgery breast reconstruction. How many ccs do i need to put in the expanders to get to a large c cup. Tissue expander for staged breast reconstruction john hopkins medicine. Many breast reconstruction patients ask me about what they can expect with tissue expanders. My breast was warm to the touch, but i had no fever nor did i have any pain. Tissue expansion is a common technique used for breast reconstruction.
Breast reconstruction begins with placement of a breast implant or tissue expander, either at the time of your mastectomy immediate reconstruction or during a later procedure delayed reconstruction. Expander implant exchange and revision breast reconstruction. The most common method of breast reconstruction currently performed in the us uses tissue expander and breast implants. I am now 3 12 weeks postmastectomy, and still very uncomfortable. Posted on february 1, 2017 in breast reconstruction, tissue expanders by dr. Hirsch em, seth ak, dumanian ga, kim jy, mustoe ta, galiano rd, et al. The technique was an improvement on that previously described by radovan in 1978 in which a temporary tissue expander needed to be replaced with a permanent breast implant. In expander based breast reconstructions, a seroma can pose a particularly difficult problem related to final tissue envelope shape as well as an increase in the risk of infection and possible tissue necrosis. This is a demonstration of the allox2 tissue expander used for breast reconstruction with allograft sling. Each dermaspan features a reinforced base that facilitates initial placement and rollout. He said im doing extremely well, and he injected 50 ccs of silicone into my tissue expander.
The expander can be placed above or below the chest muscle and can be filled with either saline or carbon dioxide depending on the type of expander used. When i was originally shown the expander it looked like a small, almost. The purpose of this study was to evaluate breast tissue expanders with magnetic ports for safety in patients undergoing abdominalpelvic magnetic resonance angiography before. For many breast reconstruction patients, the first step involves placement of a breast tissue expander a breast shaped device with an easytoaccess portregardless of whether the patient final result will be an implant reconstruction or a living. May 02, 2015 this is a demonstration of the allox2 tissue expander used for breast reconstruction with allograft sling. Tissue expansion can be a beneficial surgical alternative for many pediatric and adult patients. These pictures were taken 2 years after her mastectomy and she has completed her reconstruction and has had tattoo of her areolas and nipple reconstruction. I have surgery scheduled for the 20th to move the expander. Although an expander may be avoided, some patients may still require a secondary procedure.
The world of tissue expanders and breast implants is terrifying. Before fat grafting, the patient sits in a breast tissue expansion session to secure maximum graft take. All went well until a few weeks before i was scheduled to have the expander removed and the actual implant inserted. At the surgeons discretion, the use of a tissue expander may contribute to the benefit of the treatment. 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. When your incisions have begun healing from your tissue expander placement surgery, normally about 2 weeks after your surgery, you may begin your expansions. Ariel rad, top breast cancer reconstruction surgeon in washington dc explains the benefits of breast expansion after mastectomy surgery with breast tissue expanders. The most common method of breast reconstruction performed uses tissue expanders and breast implants. Things your plastic surgeon may forget to tell you about.
Today i talked with a woman whos had phase one of her reconstruction surgery. Permanent implants are more flexible and easier to tolerate than tissue expanders. Staged breast reconstruction involves expansion of the breast skin and muscle using a temporary tissue expander. Breast reconstruction surgery after a breast cancer diagnosis recreates the shape of the. First a tissue expander is placed to stretch the skin and create a cavity for the permanent implant. 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. Now that most of the pain from the surgery has eased, i realize that its the tes causing me the most trouble. Tissue expander for staged breast reconstruction youtube. Instructional video on how to fill a mentor tissue expander. When i tell people ive had 10 breast cancer surgeries they find it hard to believe, but after a lumpectomy, mastectomy, tissue expander, permanent implant and nipple reconstruction on just one breast, thats five surgeries right there. In most cases, the reconstruction is performed in stages starting with a tissue expander which is later exchanged for the final implant. I anticipate ill need about nine more fills at 50 ccs each until i reach the maximum capacity.
A free powerpoint ppt presentation displayed as a flash slide show on id. Mentor has release a couple new and exciting product. 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. By using a tissue expander, the breast skin can develop a new blood supply and become able to take on the weight and pressure of the implant. 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. This article provides a practical guide for successful reconstruction using current techniques and available devices. Shower with bactoshield the night before and morning of each tissue expansion.
So after a year or a year and a half i could start going more bra less but still wear one once in a while to continue the assurance or a good looking breast. Breast reconstruction may also involve more than one procedure, though followup procedures are often performed on an outpatient basis. I have emerged from the deep, dark pit of the interwebz even more confused than when i started. Patient information on breast reconstruction in the era of the world wide web. Ofteen i wil lfill about 60 cc a session sometimes more and sometimes less depending upon these factors. The expander is gradually filled with continuous expander application of sterile saline. Do breast reconstruction tissue expanders cause pain as they. Nevertheless, tissue expansion is not appropriate for every patient, because it is a time. Atlanta tissue expander pictures breast reconstruction.
If youre considering breast reconstruction, the following information may be helpful. Breast tissue expander for natural breast expansion video. Regardless of the type of expander used, this is a generally what patients can expect following surgery. What to expect during tissue expander breast reconstruction fill appointment duration. Inferolateral alloderm hammock for implant coverage in breast reconstruction. I got sooo many questions about my tissue expanders and reconstruction. My ps said to wear a bra so the scar tissue that will form around the implant will not misaline the position of the implant and it will not be crooked. Usually it depends upon how much a patient tolerates the injection but can also be impacted by factors such as radiation, chemotherapy, healing, tightness, etc. Soon i will not have these rubber baseballs on my chest this video gives a little glimpse into a special project i started. For existing patients, click here to download tissue expander reconstruction. In many cases, secondary breast revision can also be done at the time of nipple areola reconstruction.
Although this new implant is more firm, it is still. Occasionally breast reconstruction surgery is performed on the natural breast so that it will look similar to the reconstructed one. Normal scar tissue covering a stacked mammary prosthesis that was removed 3 years postoperatively for replacement. Their new breast implant is more firm, which reduces the risk of rippling in the implant. Types of tissue expander and breast implants used in.
Breast reconstruction using a tissue expander memorial. Side view of breast area with unfilled tissue expander in place. Compared to her other breast, she says the new ones too high and too perky, but she knows when all is said and done, the new breast will look more like her natural breast. How does a tissue expander for breast reconstruction. Right now i have tissue expanders first step in breast reconstruction that were placed inside my empty breast cavities. If the soft tissue over the expander is healthy, i guess you could opt to leave it in and just see what happened. Tissue contractiona new paradigm in breast reconstruction. I had my first followup appointment with my plastic surgeon this past friday. Pain from tissue expanders used in breast reconstruction is very common, but thankfully, temporary. Seromas are a common complication associated with breast reconstructive surgery. A small percentage of patients develop an infection around the expander. Last year i have my right breast removed and a tissue expander put in at the same time.
During her second operation the tissue expander was replaced for a permanent implant and left breast lift was performed for symmetry. Tissue expansion risks and safety american society of. Breast reconstruction typically involves several procedures performed in stages, and can either begin at the time of mastectomy or be delayed. I was beginning to think i had made a mistake by going with the tissue expander. This 32 yearold lady developed right breast cancer and underwent mastectomy followed by immediate tissue expander reconstruction. In fact, with skinsparing mastectomies, patients may have an excess of skin. My tissue expander toimplant exchange surgery is in just five days.
My original double mastectomy doctor thinks it is related to scar tissue, 4 surgeries in one year, and. It is a balloon like device that has a fill port usually built into the front of the device. Types of tissue expander and breast implants used in breast. Tissue expansion for breast reconstruction postoperative instructions what are my postoperative instructions.
Exercises after breast surgery with reconstruction using a. Tissue expanders for dummies breast cancer sisterhood. Oct 06, 2017 mentor has release a couple new and exciting product. Once the tissue expanders are adequately filled they are exchanged for the permanent breast implants. My breast or chest area felt tight like my breast was engorged when i was breast feeding i took vicodin for pain every 46 hours that first week then advil was enough for the pain. Placement of the permanent implant is the second procedure. Technique for seroma drainage in implantbased breast. Each tissue expander can accommodate 750 ccs of saline. You need someone to drive you to your appointment for the first 3 weeks postoperatively or as long as you requiring narcotic pain medicine. My original double mastectomy doctor thinks it is related to scar tissue, 4 surgeries in one year, and possibly the removal of a few lymph nodes. Purchasers of the informed consent resource cd are given a limited license to modify documents contained herein and reproduce the modified version for. Patient is undergoing a revision breast lift with fat grafting.
Exercises after breast surgery with reconstruction. Skinport tissue expander an expandable device intended for implantation to temporarily enlarge tissue, typically the dimensions of a skin flap where there is insufficient tissue coverage to accommodate the volume of an implantable device e. Jan 29, 2012 last year i have my right breast removed and a tissue expander put in at the same time. Today 22 days post mastectomy i answer all the questions i received. Like us on facebook follow us on twitter watch us on youtube. Some patients are candidates for directtoimplant breast reconstruction also known as singlestage or alloderm onestep whereby the permanent implant is i. Tissue expanders are temporary devices placed on the chest wall, under the pectoralis major muscle and is used to create a soft pocket to contain the permanent implant. Breast reconstruction using a tissue expander implant from the institute of reconstructive plastic surgery of central texas can help to give women a sense of feeling whole again following breast cancer treatment, with beautiful, natural results. Expands the youtube video to fill your entire web browser window. This essentially involves expansion of the breast skin and muscle using a temporary tissue expander.
Expander the expander is basically and implant with nothing in it. The tissue expander holds the place of the skin and allows the skin to be expanded to hold the final soft breast implant. Dec 29, 20 breast reconstruction and the pain in the ass known as expanders. Tissue expander to implant breast reconstruction prma.
Once secured with its suturable wings, the expander remains where positioned and will not rotate. Expanders tend to be firmer and less comfortable than permanent implants. Breast reconstruction also can be done many months or even years after mastectomy or lumpectomy. While this may occur at any time, its most often seen within a few weeks after the expander is inserted. Expander prostheses with integrated valves are particularly popular for breast reconstruction where adequate soft tissue and pocket can accommodate the added projection of the injection port. Cancer institute has a breast reconstruction brochure you can download here. Prma plastic surgery center for advanced breast reconstruction 29,483 views 4. Tissue expanders are temporary implants designed to stretch tissue after a mastectomy to prepare for breast reconstruction. Believe it or not, that made it a little more comfortable. This video will show you how to perform the exercises youll need to do after your breast surgery.
Breast reconstruction with implants and tissue expanders on vimeo. The most commonly used is the tissue expander with valve, like a balloon, which is equipped with a tiny valve, through which saline can be pumped. Tissue expansion american society of plastic surgeons. Dermaspan breast expanders our innovative line of dermaspan breast tissue expanders is ideal for latissimus flap and other breast reconstructive procedures. Right now my left side is at 325 ccs and my right is at 550 ccs.
A permanent or temporary tissue expander is first placed behind the chest muscle, usually through. Use of a doublelumen stacked expander and breast implant. Breast reconstruction and the pain in the ass known as. Nov 14, 2012 we are going to let the left tissue expander catch up to the right tissue expander before we resume fills on that side. The allox2 is fda cleared and may help avoid additional surgery from seroma, hematoma, or. The number of expansions you require will depend on your frame, the quality of your skin and tissue, as well as your goals for reconstruction. Tehrani demonstrating a breast tissue expansion on a patient before surgery. I had reconstruction at the time of my mastectomies. Infection may be seen in more than 2% of breast tissue expanders and can happen at the time of surgery or weeks and years later as infection elsewhere in the body reaches the implant. Twostage tissue expander and permanent implant breast reconstruction is one of. Post mastectomy reconstruction with a tissue expander and implant involves a staged approach.
The expanders are replaced at a second surgery by the permanent implants. No surgery was required to the opposite breast as its shape matched the reconstructed breast. In the setting of expander implant reconstruction, the first stage involves the placement of the tissue expander while the second requires expander implant exchange and revision. Ive had it drained off with a syringe a dozen times. Photos advanced plastic surgery plastic surgery grand. During reconstruction, a plastic surgeon creates a breast. This video is for patients who have had reconstruction usi. The tissue expander on the right had continued to move towards my armpit and twist around. Tissue expanders range of motion exercises week 1 youtube. Tissue expander breast reconstruction is the most common method of breast reconstruction currently performed in the u. 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. Oct, 2015 the unique medical procedures may be most deemed throughout nations around the world such as addition to australia at the same time.
G other muscles of the chest wall 3 lines to one letter learn about breast implants, and other types of breast reconstruction. What is the role of tissue expanders in recontructive surgeries. Breast reconstruction procedures emory university hospital. Women faced with breast cancer and mastectomy surgery may find more complete healing through breast reconstruction to recreate the removed breasts. Numerous studies documented that will the amount of women considering the breast reconstruction surgery can be improving on a yearly basis plus the key cause that ladies can be getting the targets as soon as the medical procedures. Tissue expander and redness but cultures all show no infection. Mar 10, 2011 there is a trend toward limiting antibiotics to a single dose given before surgery. The shift from modified radical mastectomy to skinsparing and nipplesparing mastectomy offers new options for immediate breast reconstruction. Ppt breast reconstruction powerpoint presentation free.
Recovery after tissue expander breast reconstruction surgery. I also am dealing with a seroma in the right armpit since the surgery on may 1st. A tissue expander is a temporary device that is placed on the chest wall deep to the pectoralis major muscle. This second stage of the breast reconstruction allows for the. Three to four weeks after the mastectomy, a saline solution will be injected into the expander to gradually fill it. The length of the expansion process varies depending on the amount of expansion required to reach the optimal breast size, and the type of expander used. Things your plastic surgeon may forget to tell you about tissue expanders menu. Breast implants implants are placed in a womans chest under the skin, fat, and muscle. Breast reconstruction breast cancer network australia. Doctors circle worlds largest health platform 1,984 views. Patient information on breast reconstruction in the era of the world. Outcomes of tissue expander implant breast reconstruction in the setting of prereconstruction radiation.
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