Tissue expansion relies upon the insertion of an implantable prosthesis which can be filled with saline percutaneously in order gradually to stretch overlying soft tissue. Traditionally, tissue expansion balloons were used to gain sufficient laxity of the overlying tissue before a permanent breast implant was introduced in an exchange operation.
Now, there are combined 'Becker' prostheses with both an expander and permanent gel compartments. Expansion is carried out by means of injection of saline into a port that is distant from the expander compartment. The reconstructed breast is expanded to a volume greater than the contralateral side over the period of weeks to months. When sufficient laxity has been obtained, the saline is aspirated out so that the residual prosthesis occupies a breast which has a more favourable ptosis than had just an implant been inserted. The injection port - usually sited in the axilla - can be removed under local anaesthetic.
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