Breast Augmentation: Q&A

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Expanders are Expanding Out to the Sides But Not Forward, Is This Correctable?

I wanted more cleavage than was provided in addition to wanting a larger size. It seemed that the expanders initially expanded away from my chest wall, then after a while started expanding from side to side but not front to back, so I still look fairly flat with huge roundness and no cleavage. The other issue is that one sits noticeably higher than the other. Are these issues correctable and would insurance normally cover such a procedure in IL? Seems like too much on sides, not enough in front.

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cleavage expander

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6 Doctor Answers | Asked by NotwhatIthought in O Fallon, IL

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Expanders are used to stretch the skin and muscle in preparation for placement of a permanent

Implant, and the issue you are facing is not uncommon. The tissue will tend to stretch along the path of least resistance, and that is often out to the sides. After you have been expanded, your surgeon can go back and use allograft (basically, an acellular matrix of the undersurface of skin) to hold the implant in the desired position. Alternatively, the allograft could have been placed in position at the time the expander was placed (my preference) and used to direct the... more

Tissue expanders in breast reconstruction

The tissue expanders in breast reconstruction will often follow a path of least resistance and fill upward and to the side where the skin will more easily give. Even if spot on the expander will feel round and firm, and while they will help expand a hold a space for a permanent implant, significant adjustments are made in position and size when the permanent implants are placed. Best of luck, peterejohnsonmd

How to get the right shape with expander breast reconstruction

I would need more information in order to fully answer your question but here are a few general guidelines. If the tissue expanders are placed with total muscle coverage, as was the standard for many years, the forward expansion is very limited and the lower portion tends to be flat. That is one reason why the use of an acellular matrix such as Alloderm is popular now, because it makes a sort of internal bra that helps define the shape of the breast and allow for more forward expansion. The... more

Concerns about breast configuration during tissue expansion

Without photos, a precise answer to your question can't be provided. However, just like for implants, tissue expanders need to be selected base on size and configuation to help you obtain the desired reconstructive appearance. It may be possible that not an ideal choice was made though there are several other possibilties as well. A major fact often affecting this projection during tissue expansion is having had previous radiation treatment. Differences in height and someother issues... more

Expanders will stretch your tissue

I am assuming you are having a breast reconstruction because I am not aware of using expanders in primary augmentations. That being said, breast reconstruction with expanders will always leave a somewhat flattened breast mound compared to what a natural breast looks like. There is nothing that can be done about this and I suggest to my patients that they use a crescent shaped breast enhancer to fill out the tips of their bras if it was important to them. As for position of... more

Curtis Wong, MD

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Redding Plastic Surgeon