Expander breast implants are made of a shell of silicone (the same as a normal breast implant) which surrounds an empty compartment. This compartment can be inflated with saline (salt water) to increase the size of the implant. The saline is added by injections given through a special valve attached to the implant, which lies under the skin (usually on the chest below your bra strap). This can be done in the outpatient clinic without the need for any anaesthetic.
The procedure is performed under a general anaesthetic (with you asleep) usually as a day case (in and out of hospital in the same day) or with an overnight stay.
Expander augmentation is a safe technique often used in women with breast asymmetry, to increase the size of the smaller breast. Normally, the expander is left in for about a year and then a second operation is performed to remove it and replace it with a silicone implant. The advantage with this method is that an accurate size match between your two breasts can often be achieved. The silicone implant that replaces the expander has a softer and more natural feel, which is why many women choose to have the expander replaced. Alternatively, the valve can be removed and the expander can be left in place, acting as a permanent implant.
Regarding breast implants in general, breast-feeding is still possible (and safe). Breast cancer detection by mammography is also possible (please see the breast augmentation page for further information). Importantly, you should understand that if you do not have much breast tissue to start with, the implant will be palpable (you are likely to be able to feel it) and sometimes even visible (you may even be able to see the implant lying under your skin) – furthermore, with time, breast implants will result in the gradual loss of your breast tissue.
The operation itself may take between 60-90 minutes.
Surgical drains (tubes) will be inserted into your breasts at the time of surgery – these are usually removed the following day, and you should go straight into wearing a supportive post-surgical or sports bra which you should continue wearing day and night for 6-weeks. After the surgery the wound will be dressed with medical tape. This is splash-proof and shower-proof (but not bath-proof). You will be able to shower from the day after surgery, and dab the tape dry with a clean towel, kitchen towel or use a hair-dryer on a cold setting to dry the tape. You will be able to return to light activity within a few days, depending upon how you feel.
You should avoid all heavy physical activity and contact sports for 6-weeks following the surgery to prevent damage to your new breasts. We do, however, recommend that you do light shoulder exercises after the surgery to prevent you from getting stiff. In fact, the best way to start is to wash your own hair the day after the surgery. This also has the added benefit of making you feel much better!
Expander augmentation has a high success rate with few serious complications.
These include wound infections or sometimes even infection around the implant – if significant this may require a further operation to remove the breast implant which may then be re-inserted after a 3-6 month break; bleeding (requiring return to surgery); lumpy scarring in some people; traction rippling (this describes rippling of the implant seen in your cleavage when bending forwards). Capsular contracture is an important possible complication to be aware of – this refers to a tightening of the naturally-forming scar tissue around the implant that may change the shape of the breast or cause discomfort. This would necessitate further surgery to replace the implant and release the tight scar tissue – however, as discussed above, there is normally a plan to replace the expander with a silicone implant after a year, at which time any tight capsular contracture would be released.
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