Breast Reconstruction Expanders Removal and Replacement?

In general, the time period for exchanging a tissue expander to implant just depends.  For my patients, I generally ask them to sit for a month at whatever maximum fill we have settled on.  Once they have been stretched out for a month at that size, I go ahead and exchange to the implants.  How long it takes to get to that maximal fill can really vary.  For some women it is 6 weeks after their mastectomy while others it may be 6 months.

The time for the second stage of the tissue expander/implant breast reconstruction does vary with each individual patient.  Basically, after the last tissue expansion, your plastic surgeon is awaiting an ample time for your body to take advantage of the expansion performed by allowing the pocket to be created/matured via the construction of collagen and elastin.  3 months is a typical time for the body to adequately create this pocket.  Today, with the use of acellular dermal matrix (e.g., AlloMax, AlloDerm, etc.), the time frame has been shortened since they act as a scaffold for tissue ingrowth.  6 weeks is the least amount of time that I would await prior to the exchange, but I have also waited 4-6 months prior to performing the 2nd stage.  On average 6-12 weeks is a typical time in my practice.

For most patients I would wait three months after the last expansion before the second stage.  However, there are certain circumstances where I would do it early.  Particularly in a patient who has required very little expansion (small breasts with easily expansible skin).