After mastectomy, a woman is left with one or no breasts. Fortunately for modern medicine, patients have the option to reconstruct their breasts after surgery to achieve a similar look prior to mastectomy.

Several options are available for breast reconstruction. Dr. Smiley specializes in the two most advanced techniques for breast reconstruction – tissue expander & breast implant surgery and TRAM Flap Surgery. Often time tissue expander breast surgery is preferred because it requires less downtime and leaves patients with less scars.



Utilizing a tissue expander enables the body to grow additional skin for use or reconstructive procedures. In the case of breast reconstruction after mastectomy, a silicone balloon is placed just under the skin of the chest and is slowly expanded to stretch and grow extra skin.

Sterile saline water is injected into an access port located just beneath the skin, which is a tiny tube with self sealing valve that connects to the tissue expander. Over the period of about 4 months, the tissue expander grows, which stretches the skin and makes room for a breast implant.


Although breast reconstruction through the use of a tissue expander takes significantly more time and requires many more visits to the doctor than other methods including TRAM Flap breast reconstruction, many patients prefer this method for several reasons.

Tissue expander surgery allows for:

  • Less trauma to the body

  • Less noticeable scars

  • Near perfect match of skin color, texture & hair bearing qualities

  • No risk of blood supply or nerve complications because skin remains intact


The initial procedure to place the tissue expander requires 2-4 days of immediate recovery; however as mentioned the whole process takes about 4 months. Routine injections may cause minor discomfort for an hour or two at most.

Once the skin has been stretched enough to accommodate an implant, breast augmentation surgery is performed to insert a silicone implant to re-create the appearance of the breasts. Silicone implants are used because they look and feel most natural.

Recovery from the 2nd stage after tissue expander breast surgery is the same as standard breast augmentation, requiring approximately 1 week of recovery. Please visit our BREAST AUGMENTATION page for more details.

Tissue Expander Breast Surgery Covered By Insurance

As of 1998, insurance companies are required to cover breast reconstruction after mastectomy under the Women’s Health and Cancer Rights Act. In the case of tissue expander breast surgery, this includes both tissue expansion and breast augmentation.

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