Problem.

Breasts that are not similar in size or shape due to loss of breast tissue and skin following a mastectomy.

Who is a candidate?

• Women who have had a simple mastectomy, total mastectomy, modified radical, or subcutaneous mastectomy. Women who have had a radical mastectomy may find another type of breast reconstruction to produce more favorable results.
   
• Women who desire the restoration of a complete body image with more normal breast configuration.

Procedure description.

Breast construction using an expander requires two separate surgical procedures. During the first operation, Dr. Casso places an expander under the skin and chest muscles. Over a period of months, saline is injected into the expander, allowing the overlying skin to expand and grow. When enough skin is present, the expansion process is complete and the second step is performed. Dr. Casso will remove the expander during the second procedure and replace it with a permanent saline implant. Finally, if elected, the nipple areola is reconstructed.

Recuperation and healing.

Most patients will spend one night at CHRISTUS ST. JOHN HOSPITAL, where the initial discomfort is controlled with intravenous medication. At home, patients can control the pain with oral medication. A surgical drain tube remains in place for about one week, and sutures are usually removed in 10 days.

Expansion of the expander is begun about one month after insertion, and the expansion is accomplished in four to seven, in-office expansion procedures. Light activities can be completed as tolerated, and aerobic activities can be started four weeks following either the first or second procedure.

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