By the time this is all over you will probably know more about breast cancer and reconstruction than you ever wanted to know! I promise I will not get too graphic for those who are squeamish. LOL
I have had a few questions regarding surgery and the soft tissue expanders and exactly how they work. For me, I had two surgeons the day of surgery. The surgeon removed all the breast tissue except the skin, and the plastic surgeon did the reconstruction. They did this all through a 3-4 inch incision directly across my nipple. I have no other incisions on my breast except this one. The surgeon basically takes out the lymph nodes he is looking at and the breast tissue. His job is then done. The plastic surgeon then does the reconstruction part of the surgery. In my case because I opted for double mastectomy the surgery was long (7 hours).
The whole process of achieving the final implants takes about 5-6 months following surgery. The expanders themselves feel like a rubber Tupperware lid. (They don't hurt but I can tell they are there). I can actually feel the edges of the rubber of the expanders. Upon waking from surgery there is saline in the expander, so you are not completely flat. Mine were already half filled. Every other week or so I will be going to the plastics department and they will then "fill" them with more saline until they are the desired size. After they are filled to the desired size, I then have to wait 12-14 weeks for the skin to retain that memory and then the final silicone implant is put in (simple day surgery).
Article taken from breastcancer.org
Filled tissue expander
For most women, the skin that remains after mastectomy must be stretched or expanded to make room for an implant. To stretch the skin, the surgeon inserts a balloon-type device called a tissue expander under the chest muscle. The expander has a port (a metal or plastic plug, valve, or coil). The port allows the surgeon to add increasing amounts of liquid over time (about six months), without extra surgery.
Gradually, your skin and soft tissue are stretched to achieve your desired appearance. The tissue is actually stretched a little beyond your desired size, to create a natural droop. If the tissue is stretched too far, it can cause discomfort and occasionally flatten part of your rib cage. Final steps
When stretching is done and your other treatments (chemotherapy, radiation, or both) are completed, the expander is usually replaced with a permanent implant. Breast implants are filled with either saline or silicone gel.