How long do tissue expanders stay in place?

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From the Guidelines

Expanders typically stay in for 2-6 months, depending on the individual case and the amount of expansion needed, before being replaced with a permanent implant. The duration of expander placement can vary based on factors such as the type of reconstruction, the patient's overall health, and the surgeon's preference 1. In general, the expander is gradually filled with saline solution over a period of several weeks to months to stretch the skin and muscle, allowing for the placement of a permanent implant. According to the NCCN clinical practice guidelines in oncology, reconstruction with implants can be performed either through immediate placement of a permanent subpectoral implant or initial placement of a subpectoral expander implant followed by gradual expansion of the implant envelope with stretching of the pectoralis major muscle and overlying skin followed by replacement of the expander with a permanent implant 1. Some key points to consider include:

  • The type of reconstruction used, such as implant-based or autogenous tissue-based reconstruction
  • The patient's overall health and medical history, including any underlying conditions that may affect the reconstruction process
  • The surgeon's preference and experience with different types of reconstruction
  • The need for multiple stages of reconstruction, which can affect the overall duration of expander placement. It's essential to note that the specific details of the treatment plan, including the duration of expander placement, will be determined by the surgeon based on the individual patient's needs and circumstances 1.

From the Research

Duration of Tissue Expanders

  • The duration of tissue expanders can vary depending on several factors, including the type of expander, the patient's overall health, and the complexity of the reconstruction procedure 2.
  • On average, tissue expanders are typically removed within 1 year, but some patients may require longer indwelling times, which can increase the risk of complications such as infection, readmission, and reoperation 2.
  • A study found that 12.2% of patients had tissue expanders for more than 1 year, and these patients had a higher rate of return to the operating room and complications requiring antibiotics 2.

Factors Affecting Expander Duration

  • Adjuvant chemoradiation, body mass index (BMI), overall stage, and diabetes can predict the duration of tissue expander placement 2.
  • Patients with these factors may require longer indwelling times and should be advised of the potential risks and complications associated with prolonged tissue expander duration 2.

Comparison of Expander Types

  • Carbon dioxide-based tissue expanders have been shown to have shorter expansion and overall reconstruction times compared to saline-based expanders 3, 4.
  • A meta-analysis found that gas-filled tissue expanders had a significantly lower risk of infection and required less time until definitive reconstruction compared to saline-filled tissue expanders 4.
  • However, the overall surgical outcomes for both fill types were predominantly similar, and the choice of expander type may depend on individual patient factors and surgeon preference 4.

References

1
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

3
Research

Carbon Dioxide versus Saline Tissue Expanders: Does It Matter?

Plastic and reconstructive surgery, 2016

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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