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Expander/implant reconstruction is a widely used and less invasive approach to breast reconstruction after mastectomy. This two-stage technique involves initially placing a temporary tissue expander beneath the chest muscle and skin, followed by its gradual inflation over time. Once the desired breast volume is achieved, the expander is replaced with a permanent silicone or saline implant to complete the reconstruction.

At Apollo Athenaa Women’s Cancer Centre, we offer this technique as a safe and effective option for suitable candidates, particularly those looking for shorter recovery periods and those not eligible for autologous tissue reconstruction.

How the Procedure is Performed

• Tissue Expander Placement: A temporary expander is inserted. Over the next few weeks, saline is gradually injected into the expander through a small port, gently stretching the skin to create space for the final implant.
• Final Implant Placement: Once adequate expansion is achieved, the expander is surgically removed and replaced with a permanent implant made of silicone or saline, creating the final breast.

Recovery 

• Expander Phase: This phase lasts about 2–3 months, during which the patient returns for periodic saline fills. Mild discomfort or tightness may be experienced but is usually well-managed.
• Final Implant Surgery: The second surgery involves a shorter recovery of approximately 2–3 weeks. Most patients can resume routine activities during this time, though strenuous activity and lifting should be postponed for several weeks.
• Follow-Up Care: Regular monitoring is essential during both phases to assess tissue response, monitor for complications, and guide implant selection for the final result.

Key Advantages

• Shorter Surgery Time: Since this approach does not involve harvesting tissue from other parts of the body, the initial surgery is typically shorter and less complex than flap-based procedures.
• Adjustable Volume: The tissue expander allows for gradual volume adjustments, giving both the surgeon and the patient the flexibility to achieve optimal breast size and symmetry before final implant placement.
• Less Technically Complex: Unlike autologous flap procedures, this method does not require microsurgery, reducing the overall complexity and duration of both surgeries.

Limitations and Considerations

While this technique offers many benefits, it is important to be aware of its limitations:

• Two-Stage Process: The need for two surgeries, which means multiple procedures and extended treatment timelines.
• Risk of Capsular Contracture: Scar tissue may form around the implant, leading to hardness or distortion, sometimes requiring further corrective surgery.
• Higher Infection Risk: As with any foreign device, implants carry a risk of infection or implant loss, particularly during or after expansion.
• Less Natural Look and Feel: Implants may lack the softness and mobility of natural tissue, especially in thin-skinned individuals.
• Not Ideal for Radiated Skin: Radiation can compromise skin elasticity and healing, increasing the risk of complications with implant-based reconstruction.

At Apollo Athenaa, we understand that every woman’s journey is unique. Our experienced plastic and breast reconstructive team works closely with each patient to identify the most suitable reconstruction plan while understanding aesthetic goals, medical history, and lifestyle preferences. Whether you choose an implant-based reconstruction or another technique, you will receive individualised care, surgical precision, and ongoing support at every stage of your healing.