How Much Saline is Placed in Expander at Time of Surgery?

I am wondering how much saline is typically placed at the time of expander placement?

Doctor Answers 8

How Much Saline is Placed in Expander at Time of Surgery?

It all depends upon the individual patient. In my own practice I will place enough volume in the expander to fill the available skin envelope, but not enough to place any significant tension on it.

Columbus Plastic Surgeon
4.4 out of 5 stars 21 reviews

Expander fill during initial surgery

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.

Gordon Lewis, MD
Midlothian Plastic Surgeon
4.8 out of 5 stars 23 reviews

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 to your plastic surgeon to see what he/she thinks they can achieve.  And don't worry, if you do not achieve your desired volume during the mastectomy, the expanders can be filled up after surgery in the office.   Best of luck.

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

Tissue expander breast reconstruction

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 dermal matrix are comfortably right under the skin without a lot of space, to allow the matrix to get blood supply from the skin contact and reduce the potential for accumulation of fluid (seroma). This must be balanced against the risk of causing blood supply compromise to the skin flaps from the compression of a device that is inflated significantly.

Tim Sayed, MD, MBA, FACS
Newport Beach Plastic Surgeon
4.9 out of 5 stars 17 reviews

Tissue expander

The amount of fluid placed in a tissue expander during surgery  really depends upon how tight the skin envelope is.  It is very variable.

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

Initial tissue expander volume.

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.

Stephen Delia, MD
Boston Plastic Surgeon
5.0 out of 5 stars 17 reviews

Starter volume

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

David S. Rosenberg, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 11 reviews

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.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 52 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.