This all depends on the skin left after the mastectomy. If there is a lot of skin, I have expanded as high as 500cc, more average for me is about 300-350 cc, and I have put in as little as 100 cc.
If too much is put in, it stretches the skin closure. This can lead towards wound separation and exposure of the implant. I try to put in as much as I can, but not so much that I am concerned about the skin closure.
How much can we fill your tissue expander depends on several things...
The volume we can safely fill your tissue expander depends on a few things. Is there a skin sparing mastectomy being performed? If there is enough viable skin to provide a safe envelope for the tissue expander? What technique is being utilized to place the tissue expander? total muscle coverage vs. partial muscle coverage with acellular dermal matrix (Alloderm or Strattice). Generally the use of a dermal matrix product aides in on table expansion. Talk...
There is no clear rule. It depends on how good the blood supply to the remaining breast skin envelope is, and what your preop breast shape is. Patients with very saggy, dependent breasts often have extra skin in the wrong place that has to be tailored to allow for an aesthetic closure, and that may influence how much fluid the surgeon puts in the device at the initial procedure. Many manufacturers of acellular dermal matrix materials suggest filling the expander enough so that the muscle and...
As noted, this may vary greatly depending upon a number of factors at the time of surgery and your anatomy. In general, more fluid may be able to be placed if an ADM (acellular dermal matrix) product was used. This may allow complete coverage of the tissue expander with a larger initial volume forming more of a breast mound at the time of surgery. This is quite variable and varies among surgeons.
The amount of saline injected into a tissue expander at the time it is placed can vary depending on many factors: amount of coverage of the expander by the pectoralis major, viability of the mastectomy skin flaps, whether it is a delayed vs immediate reconstruction, etc. Most often, less then 100 cc's of saline are placed, but like I said, that will vary bsaed on the judgment of the surgeon
Expander implant volume for breast reconstruction depends on several things
A tissue expander is a temporary implant, which has a "port" where saline can be injected into it at regular inervals to expand skin. With breast reconstruction, the initial volume of saline placed depends on several factors. It is imprtant to avoid putting any tension on the overlying skin, so judgment is used on a case by case basis.