XL Breast tissue expanders

     Breast Tissue Expanders are essentially saline breast implants that either have a valve attached to them that is permanent or an indwelling metallic valve(within the upper part of expander). The external valve or port is connected to the main body of the silicone shell. The tissue expanders also come in different sizes and shapes, either standard or custom. Through a special arrangement with a manufacturer, we are able to get these in XL shell volumes. 

       These are placed through a cut around the areola or infra-mammary incision and the valve is placed below the breast where it is accessible for filling and more superficial so it can be felt and filled after the filling at surgery from outside. At surgery, after the air from the tissue expender shell is removed, it is placed into either the sub-mammary (underneath the the breast tissue only) or sub-pectoral(under the breast tissue and the pectoralis muscle) after a space to accomodate these is made. With all these breast implants, the space that can usually be made larger in the sub-cutaneous than the sub-pectoral space. Then, sterile saline to the desired volume is inserted into the tissue expander(I usually use a special filling machine for XL sizes) and the valve is attached and secured to the tubing. 

       Further expansion as desired can usually begin about one month after the initial surgery and taken in increments to the desired volume. Expansion can usually be performed  at least once per week in about 50-100cc increments with a needle(butterfly type) inserted through the valve(port). They are able to be filled by our patients. Please look on youtube under Dr.Domanskis where I demonstrate filling of a XL breast tissue expander. These tissue expanders are not guaranteed by the manufacturer not to fail(leak or deflate) for longer than three months though. They are not sold as permanent implants, just temporary for breast reconstruction but many patients do have them in for much longer.  Most of the patients that many of you are aware of that are 5000+, have XL breast tissue expanders in place!

    

      For someone desiring to go greater than about 1400cc, I would definitely recommend tissuue expanders though I can use a standard 800cc breast implant saline and overfill it. However,the diameter base of a standard maximum sized 800cc saline implant is very narrow compared to that of an XL tissue expander.So, the 800cc saline implant overfilled as you can imagine does not get nearly the desired fullness compared to the xl tissue expander. Also, you need several surgeries and recoveries plus travel expenses if you are out of town which result in significant costs and almost always hardness to get to XL sizes! With a breast XL tissue expanders that I place, you can get to your desired volumes quite quickly and if you wish, can also reduce your breast size by easily removing saline from the XL breast tissue expander ports without surgery with its added costs. 

        These tissue expanders/placement are exclusively available through our office in XL sizes and surgery can be performed in US in our offices in Newport Beach/San Francisco/Miami or overseas in Italy/Anguilla. 

      Another variation that were available in the US is the Aeroform tissue expander. AeroForm® Tissue Expander System is usually placed behind the chest muscle similarly to traditional saline-filled expanders, but rather than expanding via injections of saline solution, the AeroForm uses a gradual patient-controlled release of compressed gas. This is an exciting concept for my patients for it can done by them at home without the needles, ports. Unfortunately, the maximum size is only 800cc so will not get you to XL size. I have asked the manufacturer to make custom ones larger but so far they have resisted. Keep in touch for this may change but probably only after several years! The other drawback for you XL patients is that these Aeroform tissue expanders would need to be replaced for they do feel unnatural. Unfortunately, these are no longer available.

Before/After placement of XL Breast Tissue Expanders with remote port

XL Breast tissue expansion

Dr. Domanskis is expanding the XL tissue expander through the external port. This can also be used to remove saline. Expansion can be started about 1 month after placement of XL breast tissue expanders and about 50-100cc can be injected almost every week.