Expander Implant for Tissue: Meaning, Function, Process, Potential Risks, and Beyond
In the realm of breast reconstruction surgery, tissue expanders play a significant role. These temporary implants are used to grow extra skin, primarily for breast reconstruction following a mastectomy.
Tissue expanders come in two types: textured and smooth. The main difference between them lies in their surface texture, which can influence the risks and complications associated with their use.
Textured surface tissue expanders, particularly those with the Allergan Biocell texture, carry a rare but measurable risk of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL), a type of lymphoma. This risk is notably higher compared to smooth surface expanders, which have no reported cases in controlled studies.
On the other hand, smooth expanders have an increased risk of capsular contracture, a condition where scar tissue tightens around the implant, potentially affecting cosmetic outcomes and requiring revision surgery. However, they are generally considered safer due to a lower risk of bacterial contamination and BIA-ALCL.
The choice between textured and smooth expanders involves weighing these risks against each other and the specific patient context. It's crucial to note that women with BRCA1 or BRCA2 mutations who receive textured implants may have an elevated risk of BIA-ALCL compared to those without such mutations.
Before undergoing a tissue expander procedure, it's essential to organize for someone to drive you home after the surgery. Additionally, if you smoke, you may need to quit for at least two weeks before and after the surgery due to its impact on wound healing.
The procedure involves a surgeon placing the implants under the skin and filling them gradually with saline or carbon dioxide. The purpose of the procedure will determine where the surgeon places the tissue expander.
After the expanders reach the predetermined size, a second procedure is necessary to remove them and replace them with permanent breast implants. This second surgery may be more complex in cases other than breast reconstruction.
Follow-up appointments are necessary for filling the expanders with saline or carbon dioxide. Between fills, a person may experience soreness similar to the type of soreness that can occur after working out. A main concern regarding using a tissue expander is the possibility of leakage, but the body absorbs the saline if this occurs, and the expander can be replaced.
After the removal of tissue expanders, most people can expect to begin light activity within a week of the surgery. A person may experience temporary discomfort each time the surgeon fills the expander, which should lessen within two hours.
It's important to note that BIA-ALCL is curable in most cases if a person receives an early diagnosis. If a person notices signs of infection or thinks their expanders may have leaked, including fever, foul or strong smell from the incision site, warmth or discoloration near the expansion site, swelling, severe bruising, or any other unusual symptoms, they should contact their doctor immediately.
Tissue expanders offer several advantages, including a near-perfect skin colour match, less chance of tissue death, and less apparent scars. They can also be used for repairing skin damaged by accidents, surgery, congenital anomalies, or cosmetic procedures.
The duration of treatment varies depending on the body part where the expander is placed. Recovery time from tissue expander procedures varies from person to person and can range from a few weeks to several weeks for more strenuous activities. The preparation, duration, and recovery steps will vary based on factors such as the purpose of the procedure, timing in relation to other procedures, location of the surgery, and type of anesthesia.
In conclusion, while textured surface tissue expanders carry a rare but measurable risk of BIA-ALCL, they offer benefits such as better cosmetic results, especially in revision or reconstructive cases where maintaining implant position is critical. Smooth expanders, on the other hand, have an increased risk of capsular contracture and potentially less favorable cosmetic outcomes but are generally considered safer. The choice between them involves weighing these risks against each other and the specific patient context.
- In the realm of breast cancer treatment, one must consider reconstructive surgeries, including the use of tissue expanders for breast reconstruction following a mastectomy.
- Science has identified a type of lymphoma known as Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL), which carries a rare but measurable risk with textured surface tissue expanders, particularly those with the Allergan Biocell texture.
- Health-and-wellness professionals emphasize the importance of understanding medical-conditions, such as BIA-ALCL, and its potential impact on specific patients, especially those with BRCA1 or BRCA2 mutations, when choosing between textured and smooth tissue expanders.
