Low Profile Expanders for 31 Year Old Having Double Mastectomy - Is This Right?

A natural 34B breast size 5"8' with thin frame. Plastic surgeon suggests I need low profile expander but seems more common for people to have medium. Is low profile the right choice? I will be having skin sparing mastectomy and expanded for 9 weeks before radiation begins.

Doctor Answers 8

The best dimensions of breast implants for reconstruction are tailored to your particular frame and aesthetic goals

There is no hard and fast rule when it comes to the brand, type, size, shape or dimensions of breast implants used for either breast reconstruction or breast augmentation.

Some women need moderate (medium) profile implants, while for others the lowest profile are appropriate, and in still others, high profile implants are used. 

The best fit of implant takes into account the dimensions (width) of the breast base (the "breast footprint"), the volume of the breast itself, and the degree of projection of the breast that is desired.

As long as you are seeing a well-experienced, Board-Certified Plastic Surgeon who performs a great deal of breast reconstruction, you should trust that they have selected the best implant for you!

Karen M. Horton, M.D., M.Sc., F.R.C.S.C.

San Francisco Plastic Surgeon
3.5 out of 5 stars 10 reviews

Breast reconstruction

Three basic forms of breast reconstruction exist. You can use your own tissue, implants or a combination of the previous two techniques. Your own tissue can be used in the form of the DIEP flap, PAP flap, SGAP flap or fat grafting. Implants can be done in one stage or two stage. Two stage reconstructions are started by placing expanders at the time of mastectomy. Once they expanders are placed they are able to be inflated as determined by wound healing. The final time consists of combining any of the above techniques.

If you are interested in being seen in Austin please give us a call. I know this is a difficult time for you. The majority of my practice is devoted to reconstruction for women with breast cancer or who are BRCA+

Breast expander

The choice of breast expander really depends upon how your breast looks before mastectomy.  Many times this is a low or medium height expander.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Tissue expander choice

Depending on your current breast size/shape as well as your projected reconstructive goal, you have options for low, moderate, or high profile expander.  You should discuss with your plastic surgeon what your ultimate goal is for your breast shape and size.  As you go from low, to moderate, to high profile expanders, you will be able to have larger implants as well as more fullness superiorly.  If you want to maintain 34B, you should be okay with low or moderate profile.

Sugene Kim, MD, FACS
Houston Plastic Surgeon
4.7 out of 5 stars 76 reviews

Tissue expander shape for breast reconstruction.

The choice of "profile" with a tissue expander is based upon the current breast dimensions and the overall goal of the reconstruction. In general, medium height expanders are the most commonly used. However, low height expanders can be ideal in smaller breasts or when attempting to create an accentuated tear-drop shape. During the replacement of the expander for the implant, manipulation of the pocket can be performed to correct pocket position and size.

On the issue of radiation, placement of an expander with full expansion prior to radiation may allow for reconstruction with an implant. With the addition of a dermal matrix such as Alloderm, the previous risks of capsular contracture may be improved. If you do experience tissue fibrosis and scarring which compromise the reconstruction, the use of tissue from your abdomen or back maybe used to complete the reconstruction.

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 25 reviews

Tissue expander selection

The choice of tissue expanders for breast reconstruction depends on what your surgeon is trying to create and on what your existing breasts look like.  Your existing breasts determine the width of your expander.  The projection depends on the shape that he/she is trying to create and the volume desired.  Additionally, your surgeon may be opting to create less tissue expansion as you will be having radiation.  Given the fact that you will have radiation after the tissue expansion, it should not be a major deciding factor on the expander projection.
In my practice I tend to opt for higher profile tissue expanders to allow for more tissue stretch which can then be better used to create the breast fold.  However, without seeing your pictures it is impossible to say which is the right answer.
Martin Jugenburg, MD

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 457 reviews

Low Profile Expanders

From your self description I would opt for the higher profile expanders. But remember I have never seen you in person. My best wishes from MIAMI Dr. Darryl J. Blinski, 305 598 0091

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Breast Reconstruction with Tissue Expander Implants

There are generally three types of tissue expander implants: low, medium or high "height" implants.   Depending on your anatomy (chest wall width and height), I would determine what tissue expander would facilitate the best reconstructed breast shape for you.  However, with the use of Alloderm or Strattice (also know as acellular dermal matrices = a sheet of collagen), quite frankly, the type of tissue expander utilized will likely not make that much of a difference (not much of a difference between low and medium "height" tissue expanders).   One thing that you wrote that caught my attention is that you will need radiation therapy.     Generally, radiation therapy can significantly increase the risk of scar tissue formation around your implant (also known as capsular contracture).   What most women with a tissue expander implant with radiation experience is a progressive hardening of their radiated implant.   Although it is not wrong to place a temporary tissue expander implant beforeradiation (which is very common to do), I generally recommend defintive delayed reconstruction of a radiated breast using your own tissue (also known as autologous reconstruction).  Procedures include the DIEP or TRAM flap or a Latissimus Flap + implant.   Autologous reconstruction brings new soft tissue with a new blood supply and potential new healing potential to a radiated chest wall/breast.    To learn more about your reconstructive options, please feel free to visit our website listed below.

C. Bob Basu, MD, FACS
Houston Plastic Surgeon
4.7 out of 5 stars 209 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.