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Tissue
Expansion |
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Through an
incision in the skin, with delayed reconstruction or at the time
of the mastectomy, an empty medical balloon is inserted beneath
the chest muscles. A separate valve is attached to this balloon,
which is placed beneath the chest skin and left undisturbed for
a few weeks. The balloon is gradually inflated on a weekly or
bi-weekly basis by passing a thin needle into the valve through
which a sterile solution is injected. A mild pressure sensation
may be felt during this process but the discomfort is brief and
most women find it bearable.
The gradual inflation of the balloon continues until it is
over-inflated. This ensures that sufficient skin and muscle are
available to match the larger, opposite breast, or allows the
placement of a permanent implant in situations that might
require the addition of other tissues, as in tissue transfer.
Usually, this over-inflated state lasts from four to six months
to allow for stretching of the tissues making up the mound
before the second stage is attempted. Difficulty in wearing some
clothing and certain physical limitations may be experienced
during the expansion.
Stage two involves the exchange of the expanded balloon for a
permanent prosthesis similar to that described above for a
simple submuscular reconstruction. This may be done under either
local or general anesthetic. When necessary, the shape of the
breast can be altered during this stage or the crease under the
breast can be moved or reestablished. As with submuscular
reconstruction, the hospital stay is limited. Activity levels
are similar, and post-operative discomfort is usually not
severe. The final shape of the breast mound will take many
months to finish healing.
In some cases, a permanent tissue expander is placed under the
chest muscles. This type of implant requires that only the valve
is removed (under local or general anesthetic) when the breast
has achieved its desired shape and size. The drawbacks in using
this prosthesis include the inability of the doctor to further
refine the breast after the expansion has taken place either by
altering the position of the prosthesis, repositioning the lower
breast crease, or by substituting another implant.
For those women who lack sufficient quantities of tissue despite
tissue expansion, or those with poor quality tissues left after
the mastectomy, healthy and plentiful skin, fat and muscle from
other areas of the body can be transferred to the chest (tissue
transfer).
BACK |
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Roses Grown and Photographed By
Dr. Jeffrey Rosenthal |
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