So what is the process in reconstructing the breast using the tissue expander implant? Basically what is done is during the mastectomy, whether it’s a skin sparing or a more formal mastectomy, a tissue expander is placed underneath the muscle. The muscles detach off the chest wall to allow the expander to be placed in the position. This is often covered as well with alloderm on the lower pole. So the lower crescent is covered by alloderm which is a human cadaveric skin that is processed so that the patients body does not react to it. This provides another barrier another layer of soft tissue coverage over the tissue expander for the reconstruction. This is then expanded over several weeks to months time. During the recovery phase of the patient that will start at the 2nd or 3rd week after surgery its expanded sometimes slowly sometimes more rapidly depending on the individuals tolerance. Once the tissue expander is expanded up to the volume of the desired implant a second procedure is then performed toward the tissue expander is replaced with an implant. Once this is completed, several months down the road a nipple can be reconstructed as well as the aerial around it. And that is the procedure for tissue expander to implant reconstruction.