Other clinical situations may dictate a “staged” approach whereby a temporary spacer or tissue expander may be required at the time of mastectomy.  This is most commonly indicated for individuals that may need radiation as a part of their individual oncologic care plan. A second, shorter, outpatient surgery is performed after the completion of cancer care to place the permanent breast implant.   This two-stage approach to breast reconstruction is known as “delayed-immediate” breast reconstruction.

Some women elect to complete all of their cancer treatment before starting reconstruction with breast implants. This method is referred to simply as “delayed” breast reconstruction.  Historically, a tissue expander was placed beneath the pectoralis major muscle on the chest wall.  Newer methods of “pre-pectoral reconstruction” are available whereby the pectoralis major muscle is preserved in its native position therefore avoiding animation or movement deformities of the final reconstruction implant. When tissue expanders are required as this, patients present weekly for saline injections into the prosthetic device in order to promote expansion of the chest wall skin in preparation for an implant placement during a second, shorter operation.  Breast reconstruction is available to you even years after mastectomy in this delayed fashion.