A mastectomy is a surgical procedure that removes breast tissue, including the breast cancer tumor(s) and questionable lymph nodes by a breast surgeon. Mastectomy preserves the pectoralis (or chest) muscle and leaves behind a thin layer of tissue and skin.
At the time of mastectomy, or at a later date, a tissue expander can be placed underneath the pectoralis muscle and patients usually spend one night in the hospital after a 1-3 hour surgery. Drains are also placed to remove excess surgical fluid and blood. The drains are removed in the office at subsequent visits, once the drainage volume has decreased to an acceptable level. Patients normally have drains for one to two weeks.
The tissue expander is a temporary implant that contains a port within its shell. This port allows for adding more saline or salt water, once the mastectomy incision has healed, to expand or fill the tissue expander. This process is known as expansion. Your expansions normally start several weeks after surgery and usually occur every two weeks until you have reached your goal. During a quick, in-office procedure, Dr. Burgess will use a very fine needle to place about 50mL of saline into the port of your tissue expander through a numb area on your chest skin. The pectoralis muscle may feel tight and uncomfortable that evening. Each patient has their own expansion schedule that can easily work around chemotherapy appointments, as well as their personal life. The number of required expansions is very patient-specific. Your final expanded volume depends on your individual goals for breast size, breast anatomy and how well you tolerate the overall process.
Once you have reached a volume that you and Dr. Burgess feel is acceptable, you will undergo a day surgery to remove the tissue expander and replace it with a silicone or saline implant.
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Note about these procedures: When patients come in for a new patient consult, Dr. Burgess will review the various procedures she performs as well as discuss the other options available to patients. She will help guide you towards the reconstructive surgery that most compliments your aesthetic goals, as well as maintain close communication with your other physicians.