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  Breast Reconstruction  
 


Tissue Expansion
This woman had a mastectomy several years ago and recently sought breast reconstruction. She choose to undergo initial tissue expansion and subsequent placement of a gel filled prosthesis. This involves two admissions separated by 6 weeks or so for relatively uncomplicated surgery.

During the first procedure a tissue expander is placed. This involves admission for one or two nights, whilst the second operation which involves replacement of the expander with a permanent implant may be just an overnight stay.

Pre-operative:
A range of tissue expanders
   
Pre-operative: Situation after mastectomy, before commencing reconstruction.
   
Intermediate Stage (4 weeks): The skin has been progressively expanded by filling the device with small volumes of saline during brief visits to the office once or twice a week.

 

Pre-operative:
Final result:
   
The shape of the newly created breast mound is determined by several factors including the finite number of choices in the volume and shape of available prostheses. This may result in the reconstructed breast not exactly matching the other breast. The differences often become insignificant when the patient wears a bra or swinsuit.
   

 

This patient could also have chosen to have her breast reconstructed with tissue from her lower abdomen or back. She choose tissue expansion because the surgery was much less extensive and involved fewer risks. It also has the advantage that there were no additional scars elsewhere on the body.

Other Methods of Breast Reconstruction

There are other methods of breast reconstruction which utilize the patients own tissue from the lower abdomen or back. These techniques can produce excellent results and may avoid the use of an implant. The surgery is however arguably more extensive and results in scars at the tissue donor site.

Further information about breast reconstruction can be found at the Australian Society of Plastic Surgeons.

 

 
 
Jonathan Stretch Plastic Surgeon D.Phil (Oxon) F.R.A.C.S.