What is a Typical Timeframe To Keep in Tissue Expanders After Final Fill?

Many plastic surgeons differ somewhat on their tissue expander timeline for breast reconstruction.  Most agree that the expanders do need to be in place for somewhere between 3-6 months before being removed for the second stage procedure to place permanent implants.  There is no absolutely correct answer to your question.  Surgeons work off the timeline they feel most comfortable with.  For myself, I keep the tissue expanders in place for a minimum of 4 months total and 3-4 weeks following the last expansion in general.  However, I have many patients go through chemotherapy at some point and we delay things while their immune systems are so fragile.  So, it is not uncommon for me to be performing the second stage procedure 6 months or so after the first.  It can even be put off longer if the patient desires.  It sounds like your plastic surgeon may have a reason for his game plan.  If you wish to delay it, call his office to discuss it further and find out more about the rationale.  You guys may be able to reach a compromise on the timing.

There is no set time on when to exchange tissue expanders for the final implant in breast reconstruction.  Typically around 4 weeks gives the tissue time to "settle" before final placement.  If you have specific questions I would recommend talking to your surgeon.  Hope this helps.

Expanders are used to expand the skin to make room for an implant. In general the expander can be removed whenever this process is complete. I usually wait a month after the final fill but if you have had your expanders in for a while and the capsule is mature and the current size is right expander exchange shouldn't be an issue at anytime. If you have concerns I'd talk more with your surgeon as there is no harm is waiting too. Good luck, Dr K

The reason for a waiting period after the last expansion before replacement of tissue expanders with implants is that the tissue needs to have time to stretch and accommodate to the increased size. I usually prefer to wait around 6 weeks for this process to occur. Of course, each case is unique so it is important to speak to your board certified plastic surgeon.

There really is not set time to wait until you replace your tissue expanders. I like to expand to a volume about 20-25% higher than the  final volume for the implant.  I will usually keep patients at that volume for about 4-6 weeks and then exchange them. If life or other events are taking place that prevent the patient from having the exchange it is ok to do it a few months later.

There are a wide variety of opinions on the optimal time to perform your implant exchange (removal of tissue expanders and placement of permanent slicone or saline implants).   I generally advise patients to wait at least 4 weeks to allow the tissue expanders to "settle."    Having said that, you can easily wait several months to have your implant exchange procedure.     I'm sure your PS has a good reason for his/her recommendations.  If you feel uncertain about his/her recommendations, I'm sure your PS would not mind giving you a name of a trusted colleague for a 2nd opinion consult.   Best of luck.

Dr. Basu