STAGE I – Mastectomy & Expander

Breast Reconstruction 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. Dr. Davison will place the tissue expander under the same anesthesia as your mastectomy surgery if possible. This is called immediate reconstruction since the process is started at the time of your mastectomy.  You may choose to “delay” the start of reconstruction and wait for a few weeks or months.  This is called delayed breast reconstruction.

Here are the steps involved in mastectomy with expanders:

1.  During the mastectomy your breast surgeon removes skin and breast tissue – leaving the chest tissue flat and tight.  An expander (balloon type expandable device) is put into place under the chest muscle and skin – to serve as a space saver – into which a breast implant is later placed.  The expander is gradually filled with saline solution – over several weeks – and slowly stretches the remaining chest skin and muscle to allow for the future breast implant.
2.  Expander surgery is performed under general anesthesia in an operating room. Often a Biologic tissue barrier is used to create an inner Bra to cradle the expander.
3.  The incision used to perform your mastectomy is used for the expander placement
4.  After placement – the incision is closed
5.  Drains are left in place – and are removed when only 30cc fluid comes up
6.  Healing takes 4-6 months – the surgery takes several hours and is done under one anesthesia.  If delayed expander placement is done – surgery takes 1-2 hours.
7.  Breast implant is placed when Dr. Davison determines the space is sufficient and the expander is removed.  The same incision is used to do implant placement.
8.  A nipple and areola is created typically 3 months later – with additional beautification for both breasts.
9.  Dr. Davison becomes your primary care physician over the next year during this entire process.