Breast Reconstruction Expanders Removal and Replacement?

How long are Breast reconstruction expanders left in after the last fill? I had my expanders removed and replaced at approximately 6 weeks. From what I have heard it seems that the usual time is about 3 months so the skin flap can mature is this true?


Doctor Answers 7

Breast tissue expansion time

The traditional teaching was that a minimum of 3 months was needed to achieve optimal tissue expansion on breast reconstruction. Recent experience has caused many surgeons to rethink this guideline. In addition to what has already been discussed, another variable that determines how long to leave the tissue expander is if an acellular dermal matrix (Alloderm or similar product) was used as part of the reconstruction. Recent studies have shown that there is a shorter expansion period with the use of these products since the expander can be filled to a higher volume at the time of surgery. So depending on your skin, breast size and details of the reconstruction, a shorter expansion time may be appropriate.

Chicago Plastic Surgeon
4.9 out of 5 stars 68 reviews

Exchange to Expander Varys With Every Patient

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.

Christopher V. Pelletiere, MD
Barrington Plastic Surgeon
4.8 out of 5 stars 73 reviews

Time to remove breast expanders for reconstruction

In general, I leave expanders once fully inflated for 3 months. The removal/replacement process, however, can vary with repect to the size of the expander to the size of the implant. If you have a large expander and a small implant going in, you may not need as long as 3 months to the skin to stretch, relax, and make more collagen and elastin.

Barry E. DiBernardo, MD
Montclair Plastic Surgeon
4.1 out of 5 stars 50 reviews

Time until exchange of tissue expander for implant

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.

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 26 reviews

Expander and implant exchange

Usually it takes a few months maybe 3-6, but in some cases where it was more a skin sparing mastectomy, the expansion rate is quicker.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Breast reconstruction expander exchange

The time for expander removal and implnat replacement varies form surgeon to surgeon. There was a recent article that examined this and found no difference in the final outcome when waiting 1 month or 6 months after the last expansion.

I like to wait a minimum of 6 weeks but most of the time I switch them out at 3 months. I do examine my patients often to see if there are skin changes following the last expansion. I hope this helps.

Michael Diaz, MD
Melbourne Plastic Surgeon
5.0 out of 5 stars 20 reviews

Yes, three months is my preference

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). 

York Jay Yates, MD
Salt Lake City Plastic Surgeon
4.9 out of 5 stars 175 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.