Breast Bioengineering with Tissue Expansion, Implants, and Allodermin Darien

During a mastectomy all of the breast tissue is removed, leaving behind a thin envelope of your own breast skin. Dr. Passaretti works closely with your breast surgeon to design your mastectomy and incisions for the best possible cosmetic result. His long and close relationships with the leading breast surgeons in the area allows an integrated, team approach, ensuring you the best care.

Immediately following your mastectomy, Dr. Passaretti will elevate your chest muscle and use this in conjunction with Alloderm to create a sling or pocket to hold your tissue expander in place. Your own breast skin is then gently redraped around the new breast, minimizing stress and tension. Tissue expanders are temporary, adjustable implants that help prepare the tissue for the final reconstruction by acting as a mold for your new breast. Once positioned under the pectoral muscle, tissue expanders are gradually inflated over a period of two to four weeks as swelling from the surgery subsides and your tissue recovers. As the tissues fuse, regenerate, and heal together, they will adopt the new shape of the tissue expander.

These devices can also gradually stretch the skin and make room for larger implants if the patient desires. This method can also keep the nipple and areola intact during mastectomy to improve the overall outcome. In some cases, "nipple preservation" has provided a result so natural, it's hard to tell the breast was ever altered.

After the skin and soft tissue has stabilized, the tissue expander is removed during a small out-patient procedure and replaced with a permanent breast implant. As a final step, many patients will benefit from fat grafting. During this small outpatient procedure, fat is harvested from the abdomen and lower body through small 3 mm incisions. The fat is then injected into and around the breast. As your own tissue grows into the breast it helps to create soft, smooth, and natural contours. Combining all of these treatments, Dr. Passaretti is able to "bioengineer" a very soft, natural-looking breast and bust contour. Tissue expanders, unlike when tissue is harvested from other areas of the patient's body, require less time in the operating room, less time spent recovering, and leaves no unattractive donor site scars.