Tissue expansion is a procedure that enables the body to “grow” extra skin by stretching adjacent tissue. A balloon-like device called an expander is inserted under the skin where the breast was moved, and then gradually filled with salt water over time, causing the skin to stretch and grow. The time involved in tissue expansion depends on the individual case and the size of the area to be repaired. The advantages of tissue expansion are many-it offers a near-perfect match of skin color, sensation, and texture; the risk of tissue loss is decreased because the skin remains connected to its original blood and nerve supply; and scars are often less apparent than those in flaps or grafts. The expander temporarily creates what can be an unsightly bulge, making this option undesirable for some patients. Previous or future radiation therapy to the site of disease is a relative contraindication to tissue expansion and permanent implant placement. The majority of patients who undergo this type of breast reconstruction who also receive radiation therapy have an undesirable outcome, frequently resulting in removal of the implant. Restoration of the nipple and areola follow. Scars fade substantially with time. The reconstructed breast will likely differ in contour and feel to the natural breast.
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