Tissue (Skin) Expansion after Mastectomy
Tissue expansion is a means of stretching the skin or muscle of the chest to allow for an implant. It can be done at the time of the mastectomy or later. During surgery, an expander is put beneath the skin. Over 3 to 6 months, the device is slowly inflated using salt water. As the expander is inflated, the tissue stretches. This is done in the doctor’s office.
A second surgery is needed to remove the expander. At the same time, the implant is inserted.
Planning for Surgery
- Plan to take off work for 2-4 weeks. It depends on the type of work that you do. Avoid strenuous activity for about 4 weeks.
- Do any household and outdoor chores ahead of time or make plans for someone to help you.
- Plan meals that are easy to prepare.
- Your hospital stay will be from 1-2 days.
- Eat well. Healthy eating helps wound healing.
- You will have “drains” or small tubes placed during surgery to drain away excess fluid. The drains may stay in for up to one week. Your nurse will show you how to take care of them before you go home.
- Wear loose comfortable clothing for a few days. We suggest shirts that button down the front.
- Plan to visit your surgeon in 2 – 5 days and every couple of weeks for the next few months.
Incision Care
- You may go home with a dry dressing over your incision. This dressing needs to be removed each day. A new gauze dressing should be put on as needed. After one or two days, no dressing is needed unless there is drainage coming from your incision or you are more comfortable with the incision covered.
- You will be told about bathing and when you can get your incisions wet. This is most often 1-2 days after your surgery.
- Most often, stitches will dissolve. You will be told which type of stitches you have, in case you have some that need to be removed.
- Watch for signs of infection.
- Redness and swelling at the site.
- Warmth to the touch.
- Increasing pain that doesn not go away when you take your pain medicine.
- Drainage that has a pus like appearance to it or a foul smell.
- Temperature greater than 100.5° F for two readings taken 4 hours apart.
The Expansion Process
The expansion process most often begins 2-4 weeks after surgery. A breast expander is the inflatable device placed beneath the skin. A needle will be put through the skin to place saline into the expander. Patients are often numb at this site. During this process your skin will be checked for changes in color, warmth, and excess tightness. If you have any pain or trouble breathing while the saline is being put in, you should tell your doctor or nurse.
You can expect to return to the clinic every 1 – 2 weeks to repeat this process until the tissue (skin) is enlarged enough for placement of a permanent breast implant. The tissue is over-expanded to make space for the permanent implant. The tissue expansion process should take 3 to 5 months. Often, the expander will produce an “unusual breast shape”. Do not be alarmed as the purpose is only to stretch the underlying tissues. Seldom do they appear as a normal breast. This should be achieved when the final implant is placed.
Activity
- Strenuous exercises should be avoided for 4-6 weeks.
- You should not drive while you are taking prescription pain medicine.
- Do not lift anything greater than five (5) pounds for 1-2 weeks.
When to Call the Doctor
- Bleeding.
- A fever over 100.5ºF for two readings taken 4 hours apart.
- Increased pain not controlled with medicines.
- Nausea and vomiting.
- Wound drainage that contains pus or is foul smelling.
- Redness or increased tenderness along the suture line.
Phone Numbers
If you have questions or concerns call us.
Plastic Surgery Clinic: Mon. – Fri. 8:00am–4:30pm (608) 263-7502.
After hours this number is answered by the paging operator. Ask for the Plastic Surgery Resident on call. Give the operator your name and phone number with the area code. The doctor will call you back.
If you live out of the area, please call: 1-800-323-8942
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 08/11/2011
Copyright © 08/11/2011 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#4534
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