Tissue Expanders Case Study

Tissue Expanders

A tissue expander is a device that is made from elastic silicone rubber. During the mastectomy, this balloon-like device is placed after the surgeon removes skin and tissue to allow for placement of the tissue expander beneath the remaining muscle and skin of the patient’s chest.

The tissue expanders are inserted either empty or with a minute amount of saline in them. As time passes, sterile saline fluid is added to the expanders: This is accomplished by inserting a small needle into the filling port of the expander and adding sterile saline fluid. As the expanders are gradually filled, the tissues over the expanders begin stretching. The expander creates a breast-shaped pocket where Dr. Gershenbaum can place the patient’s
breast implant.

Expansions are performed at Dr. G Cosmetic Surgery Center in Miami. The expansion process generally begins within a few weeks of the patient’s mastectomy and continues for a week or two until the tissue expansion is complete. Each patient is unique, therefore, Dr. Gershenbaum monitors each patient’s progress until the tissue expansion is adequate for providing the patient with the breast size she desires.

Breast Reconstruction Surgery – The Specifics

Reconstruction surgery may be able to be completed in combination with a mastectomy or at any time after the mastectomy and treatment.

There are various kinds of reconstruction procedures available in Miami:

Transverse Rectus Abdominal Muscle Flap (TRAM)

During this procedure, Dr. Gershenbaum uses abdominal tissue to reconstruct the patient’s breast. This surgery is similar to a tummy tuck (abdominoplasty), however, the tissue that is typically discarded is used for reconstructing the breast. With this type of reconstruction, no implant is necessary and unwanted abdominal fat, and skin are removed. In addition, muscle may be taken from the abdomen.

Deep Inferior Epigastric Perforator Flap (DIEP)

This procedure is comparable to the TRAM reconstruction procedure except only skin and fat are taken from the abdomen (no muscle).

Latissimus Muscle Flap

Dr. G uses natural tissue from the back to reconstruct the patient’s breast. The size of breast the patient desires determines whether or not an implant is utilized during a Latissimus Muscle Flap reconstruction.

Fat Grafting

Fat grafting can be used as a tool to assist Dr. Gershenbaum as he creates the shape of the reconstructed breast. Fat grafting can provide a more natural, soft shape to the breast and can be used after implant or flap reconstruction.

Superficial Inferior Epigastric Perforator Flap (SIEP)

The SIEP Flap is also similar to the TRAM reconstruction and just as the DIEP Flap only uses fat and skin from the abdomen (not muscle), so does the SIEP Flap.

Breast Reconstruction Recovery

Directly after surgery, patients receive a surgical bra.
This bra helps reduce inflammation and provides support for the newly reconstructed breast(s). Dr. Gershenbaum will place a drainage tube to ensure that excess fluid and blood does not accumulate within the tissues. Dr. G provides his patients with medications for nausea and pain.

Each patient receives specific instructions concerning eating, bathing, restrictions and medications. Prior to leaving the hospital, patients will most likely receive information related to their first post-operative visit at Dr. G Cosmetic Surgery in Miami.

For about two weeks after reconstruction, patients will need to limit their activity. Following this two-week period, patients are usually permitted to return to work. After about six weeks, patients can become more active and typically begin exercising again.

Dr. Sam Gershenbaum’s dedication to his patients, caring demeanor, experience and skills make him one of the premier plastic and reconstructive surgeons in South Florida. If you are considering a mastectomy or have already had a mastectomy and you would like to learn more about a breast reconstruction with Dr. Gershenbaum, contact Dr. G Cosmetic Surgery Center in Miami at [phone] or click here to fill out our online contact
form.