Tissue Expander

Conveniently located to serve St. Louis, Missouri

tissue expander breast reconstructionIf you are having or have had a mastectomy, you may be a candidate for this procedure. This procedure may be done at the time of mastectomy (immediate) or at a later time (delayed). Dr. Cabbabe will help advise you if you should consider surgery on the opposite breast if you are unsure. He will also help you to determine whether you are a candidate for nipple sparing mastectomy or require more aggressive skin removal. He will also discuss immediate one-stage direct to implant reconstruction versus two stage tissue expander then implant reconstruction.

If reconstruction is done at the time of mastectomy, Dr. Cabbabe will follow the breast surgeon into the operating room and insert an inflatable temporary tissue expander either above or under the muscles of the chest. A biologic, regenerative is often used to enhance the result, decrease the risk of capsular contracture scarring and to reduce visible rippling of the implant. New technology is used to evaluate blood flow to the skin on the chest after mastectomy. A drain will be placed between the muscles of the chest and the skin. If you have already had a mastectomy, the same steps are done. You will need to stay one to two nights in the hospital.

After discharge, Dr. Cabbabe will begin to inflate the tissue expander in the office, as early as one week after surgery. The needle will not hurt because the skin of the breast will be numb from surgery. He will inflate the expander at regular office visits until the desired size is achieved and then slightly larger for the second stage surgery . After the desired size has been reached, a second stage surgery will be done. During this procedure, the temporary tissue expander is removed, the capsule, or scar tissue around the breast, is manipulated and released in order to provide optimal shape and size. A permanent saline or silicone implant is then placed. This is often done as an outpatient procedure. Fat grafting to the upper chest is often incorporated as needed to enhance the final result. A breast lift or breast reduction may be needed on the other breast in order to improve symmetry. A new nipple can be made and areolar tattooing can be done if desired.

Dr. Cabbabe incorporates his experience with reconstructive and cosmetic surgery of the breast to give his patients the best results possible to meet their desires. He is an expert in cosmetic, reconstructive and minimally invasive breast surgery. During your consultation, Dr. Cabbabe will carefully examine you and will make recommendations in order to help you achieve your desired result.

We believe that patients, their desires, and anatomy are all unique. Dr. Cabbabe believes that the key to a successful surgery is proper planning and discussion with the patient about their goals. Therefore, Dr. Cabbabe evaluates each patient and creates a customized surgical plan for all of his patients to meet their expectations. To schedule a consultation, call us at (314) 842−5885 or complete the contact us (hyperlink to contact page) form.

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Good candidates for this surgery are women who have small to medium breasts that do not have a significant degree of droopiness. Otherwise, it can be difficult to obtain symmetry with the other breast, even with a lift or reduction. If you are having or have had both breast removed, you may be a good candidate as well.

Poor candidates for this surgery are women who have had prior radiation and mastectomy. The skin is very difficult to stretch in this condition and leads to an increased risk of skin breakdown and implant exposure, necessitating removal. Dr. Cabbabe will often recommend a flap type of reconstruction in this case.

Preparing for Surgery

Dr. Cabbabe will ask that you refrain from taking any aspirin, plavix, Coumadin or any other type of blood thinner. If you are taking chemotherapy, this may need to be finished or held prior to surgery.

Your Tissue Expander will be performed in a hospital or surgery center in St. Louis, MO.


You will be admitted to the hospital for one to two nights. Pain medication and antibiotics will be prescribed. There may be some numbness on the breast which improves with time. Most patients are able to shower within 24 hours. No drains are needed in the breast, but one may be placed in the axilla or armpit if you had an axillary dissection.

Types of Reconstruction:

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