Understanding your options with breast reconstructive surgery

Q. I recently had a mastectomy and I went to my doctor for checkup. He said everything is fine and that to have a reconstruction procedure, I would need a tissue expander. Can you tell me what a tissue expander is and what I can expect?

A. The good news is that you're on your way to recovery! A tissue expander is a silicone balloon that is placed underneath your skin. This may be done during your initial mastectomy or many years later when the patient feels that reconstructive surgery is right for them.

It is placed in your chest so that you can “grow’’ skin over time. Once you heal, your doctor will likely ask you to come to the office to start the “expanding’’ procedure.

The expanding procedure entails injecting sterile saline into the silicone balloon. This is done with local anesthesia in an office procedure. The silicone balloon has a one-way valve and is used to inject saline through the skin.

After approximately one to two months, the expansion is complete. The skin is expanded to slightly larger than your other breast to get ready for the reconstructive procedure.

Your reconstructive procedure can be placement of a breast implant or reconstruction with different muscle flaps. The areola, or tannish part of your breast, is repaired after the expansion is done.

Discuss this all with your doctor. The quality of your reconstructive procedure is based on the experience of your physician. Like any other procedure, make sure to pick a physician who does many breast reconstructive procedures.

Dr. Carlos Wolf is a partner in Miami Plastic Surgery and is board certified. Email your questions to him at: