Breast reconstruction with a saline-filled breast implant usually occurs as a two-stage procedure, starting with the placement of a breast tissue expander, which is replaced several months later with a breast implant.

Stage 1: Tissue Expansion During a mastectomy, the general surgeon often removes skin as well as breast tissue, leaving the chest tissues flat and tight. To create a breast shaped space for the breast implant, a tissue expander is placed under the remaining chest tissues.

The tissue expander is a balloon-like device made from elastic silicone rubber. It is inserted unfilled, and overtime, small amounts of sterile saline are added by inserting a small needle through the skin to the filling port of the device. As the tissue expander fills, the tissues over the expander begin to stretch, similar to the gradual expansion of a woman's abdomen during pregnancy.

The tissue expander creates a new breast shaped pocket for a breast implant. Tissue expander placement occurs under anesthesia in an operating room. Operative time is generally one to two hours. The procedure may require a brief hospital stay, or be done on an outpatient basis. Typically, you can resume daily activity after two to three weeks.

Post Mastectomy
Stage 1:
Tissue Expander
Because the chest skin is usually numb from the mastectomy surgery, it is possible that you may not experience pain from the placement of the tissue expander. However, you may experience feelings of pressure or discomfort after each filling of the expander, which subsides as the tissue expands.

During this first stage of implant reconstruction, the plastic surgeon ensures that the pocket created by the tissue expander is positioned correctly and is the desired shape and size. Based on the result of the expansion, the surgeon selects a breast implant to replace the tissue expander.

Stage 2: Placing the Breast Implant After the tissue expander is removed, the unfilled breast implant is placed in the pocket, and then filled with sterile saline. The surgery to replace the tissue expander with a (implant exchange) is usually done under anesthesia in an operating room. It may require a brief hospital stay or b e d o n e o n a n outpatient basis.

The type of breast implant used will be determined by you and your plastic surgeon by evaluating the dimensions and shape of your desired breast. Breast implants are available in round and contoured shapes in a wide variety of sizes. Stage 2: Breast Implant and Nipple/ Areola Reconstruction