The Breast Reconstruction Guidebook

Unless you are replacing small, A-cup breasts, most implants will not immediately fit under your chest muscles after mastectomy. Temporary saline implants called tissue expanders are used to gradually stretch the chest skin and muscle to make room for a fixed-sized implant. Similar tissue expanders are commonly used by plastic surgeons to rebuild damaged facial features and replace tissue damaged or burned.

Empty tissue expanders are first placed under the pectoral muscle after the mastectomy, and a small amount of saline is then added. This pushes the muscle forward and creates a little bulge. Over a period of several weeks, this "starter" breast grows as more saline is gradually introduced into the expander. Once the expanders are filled to the desired volume, the new breasts are allowed to "settle" for several weeks. Then, in a brief operation, the expanders are exchanged for the saline or silicone implants.

Most women complete this process in six to eight weeks. Your own interval may be shorter or longer, depending on how much your skin must stretch to accomodate your implant, and how well you tolerate the process.