Do expanders fill from top to bottom?

A tissue expander is like a balloon.  As it fills, the entire expander fills.  However, the shape of the expander is such that as it fills more and more towards its capacity, the bottom expands more ( tear drop shape).  Often you do not see the bottom expansion until you get closer to the optimal fill - for example, a 600cc expander might not show much in the lower pole until you get past 400cc.  It also can take time for the bottom of the breast to stretch more which is why some surgeons will leave the expanders on for quite awhile.  I hope this helps.

Generally speaking, expanders have a slightly different shape than most implants. When expanders are filled they should expand uniformly but there is some effect of gravity on the saline that is placed inside the expander.Often, as expansion progresses, wrinkles and folds tend to go away. If they remain at the time of surgery, we try to correct this.

If the expander is a little high, when the expander is exchanged, the pocket can be lowered. Best of luck.