Table of ContentsView AllTable of ContentsSignsCausesDiagnosisTreatmentPreventionCopingFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Signs
Causes
Diagnosis
Treatment
Prevention
Coping
Frequently Asked Questions
In preparation for breast implant placement after amastectomy, a breast tissue expander may be used. Abreast tissue expanderis an implantable, balloon-like device used to stretch breast skin and chest wall muscles. Over the course of two to six months, the expander will create a pocket so that a permanent saline orsilicone implantcan be inserted as part of breast reconstruction surgery. Though usually a safe procedure, the tissue expander has the potential of rupturing.
Although a rupture is not a medical emergency, it may require quick intervention and, often, surgical replacement or removal of the device.
This article will review the signs of tissue expander rupture and its causes. It also addresses prevention and treatment.
How Do You Know if Your Breast Tissue Expander Has Ruptured?
The rupture of a breast tissue expander may not be all that noticeable at first. If the tissue expander leaks, you may experience a gradual decrease in your breast size or notice that the shape of your breast gradually changed.
A traumatic injury or excessive compression may cause the implant to burst or pop, which can cause an immediate change in breast size or shape.
For instance, if the rupture occurs at the top of the device, the top part of the breast may suddenly flatten. If the rupture occurs near the bottom, you will likely experience an overall deflation of your chest cavity. Because the device is filled with a saline (saltwater) solution, the body will gradually absorb the fluid.
Rupture is not all that can go wrong with breast tissue expanders. If a rupture is not treated promptly, an infection may develop.
Verywell / Gary Ferster
Causes of Breast Tissue Expander Rupture
A breast tissue expander will often be placed during a mastectomy, either under thepectoralis(chest) muscle or over it. If other cancer treatments are planned, a separate surgical procedure may be scheduled after additional therapies are completed.
The implants themselves are quite sturdy and designed to be left in place for months. However, they can rupture.
Some of the causes of tissue expander rupture include:
Risk Factors
Some factors may increase the risk of tissue expander ruptures. but, surprisingly, they are not what many people imagine them to be.
A 2017 review of studies from Japan suggested that large breast size and smooth expander implants are the only two relevant risk factors for tissue expander ruptures.
Capsular contraction, the hardening of the breast cavity tissues, can also reduce the available space within the breast cavity, increasing the risk of overfilling.
Obesity, older age, diabetes, smoking, orradiation therapymay slow postoperative healing and/or increase vulnerability to infection. but these factors do not increase the risk of a tissue expander rupture.
Diagnosis of a Breast Tissue Expander Rupture
Even if a rupture is apparent, your healthcare provider will order an imaging study (such as anultrasoundorbreast MRI) to check for bleeding, infection, or other internal abnormalities.
It is important not to rush into treatment without first completing these imaging tests. Your insurance company may deny your claim for a replacement if you have not provided them with evidence of the rupture.
Treatment for Breast Tissue Expander Rupture
A breast tissue expander will almost always be removed if a leak or rupture has occurred. The only exceptions may be if the leakage occurred somewhere near the external port or if you are near the end of your expansion procedure.
If a rupture occurs near the end of the expansion process, the surgeon may recommend removing the expander and moving straight to the permanent breast implant if the cosmetic results are deemed acceptable. This might mean opting for a permanent implant that is slightly smaller than you had originally planned.
Preventing Breast Tissue Expander Rupture
Breast tissue expanders can rupture for any number of reasons. While there is no way to predict if and when a rupture might occur, there are several things you can do to reduce your risk:
Always speak with your health insurance company to know which costs are covered and which are not. Remember that “more expensive” doesn’t always mean “better.” Listen to your healthcare provider and do your homework to ensure the optimal appropriate care.
Tips for Managing Tissue Expander Pain
Coping With Breast Tissue Expander Rupture
The rupture of a breast tissue expander can be emotionally draining as it adds yet another procedure to an already extensive roster of treatments. There is no minimizing the emotions you may feel. The setback can raise doubts and fears about your mortality and/or appearance or exacerbate feelings of loss anddepression.
As much as people may tell you to “hang in there,” don’t bury your emotions or put on a good face. Share your feelings with friends, family, and your medical team. If you are feeling isolated, find a support group or ask youroncologistfor a referral to a therapist or psychiatrist who can help. Don’t face these or other setbacks alone. There is help.
Summary
Breast tissue expanders are used to improve outcomes for breast implants following mastectomy. Though this procedure is often done safely and without complication, there is a risk of expander rupture. If the expander ruptures, it deflates and the body absorbs the saline inside.
The expander will then need to be surgically removed. Then, a new expander may need to be placed or possibly replaced with the final implant.
Frequently Asked QuestionsDuring the placement of tissue expanders and when they are filled with saline, you may feel pain or discomfort; however, it should not be severe.A breast tissue expander looks like an empty breast implant. Over time, the expander is filled with a saline solution to help stretch the tissue and skin to the breast size that you and your surgeon have decided on.Symptoms of an infected breast tissue expander can include fever, redness of the breast, swelling, or pain.It is typically understood that the expander should be left in for no longer than one year.
During the placement of tissue expanders and when they are filled with saline, you may feel pain or discomfort; however, it should not be severe.
A breast tissue expander looks like an empty breast implant. Over time, the expander is filled with a saline solution to help stretch the tissue and skin to the breast size that you and your surgeon have decided on.
Symptoms of an infected breast tissue expander can include fever, redness of the breast, swelling, or pain.
It is typically understood that the expander should be left in for no longer than one year.
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Fujii T, Yajima R, Kuwano H.Implications of long-term indwelling of tissue expander in breast reconstruction: risk of expander rupturing.Anticancer Research. 2016;36(8):4337-4340.Breastcancer.org.Breast implant rupture. Updated October 29, 2020.Suga, H.; Shiraishi, T.; Tsuji, N. et al.Risk factors for complications in expander-based breast reconstruction: Multivariate analysis in Asian patients.Plast Reconstr Surg Glob Open.2017 Nov;5(11):e1563. doi:10.1097/GOX.0000000000001563Suga H, Shiraishi T, Tsuji N, Takushima A.Risk factors for complications in expander-based breast reconstruction: multivariate analysis in Asian patients.Plas Reconstr Surg Glob Open. 2017;5(11):e1563. doi: 10.1097/GOX.0000000000001563Breastcancer.org.Breast implant reconstruction. Updated January 18, 2021.Memorial Sloan Kettering Cancer Center.Breast reconstruction using a tissue expander. Updated October 14, 2020.Breastcancer.org.Infection after breast implant reconstruction.Additional ReadingBeak, W.; Lew, D.; and Lee, D.A Retrospective Analysis of Ruptured Breast Implants.Arch Plast Surg.2014 Nov;41(6):734-9. doi:10.5999/aps.2014.41.6.734.Payne, R.; Bello, R.; Siotos, C. et al.Abstract: Tissue Expander Failure in Breast Reconstruction.Plast Reconstr Surg Glob Open.2017 Sep;5(9 Suppl):114. doi:10.1097/01.GOX.0000526328.32234.a6.
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Fujii T, Yajima R, Kuwano H.Implications of long-term indwelling of tissue expander in breast reconstruction: risk of expander rupturing.Anticancer Research. 2016;36(8):4337-4340.Breastcancer.org.Breast implant rupture. Updated October 29, 2020.Suga, H.; Shiraishi, T.; Tsuji, N. et al.Risk factors for complications in expander-based breast reconstruction: Multivariate analysis in Asian patients.Plast Reconstr Surg Glob Open.2017 Nov;5(11):e1563. doi:10.1097/GOX.0000000000001563Suga H, Shiraishi T, Tsuji N, Takushima A.Risk factors for complications in expander-based breast reconstruction: multivariate analysis in Asian patients.Plas Reconstr Surg Glob Open. 2017;5(11):e1563. doi: 10.1097/GOX.0000000000001563Breastcancer.org.Breast implant reconstruction. Updated January 18, 2021.Memorial Sloan Kettering Cancer Center.Breast reconstruction using a tissue expander. Updated October 14, 2020.Breastcancer.org.Infection after breast implant reconstruction.Additional ReadingBeak, W.; Lew, D.; and Lee, D.A Retrospective Analysis of Ruptured Breast Implants.Arch Plast Surg.2014 Nov;41(6):734-9. doi:10.5999/aps.2014.41.6.734.Payne, R.; Bello, R.; Siotos, C. et al.Abstract: Tissue Expander Failure in Breast Reconstruction.Plast Reconstr Surg Glob Open.2017 Sep;5(9 Suppl):114. doi:10.1097/01.GOX.0000526328.32234.a6.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Fujii T, Yajima R, Kuwano H.Implications of long-term indwelling of tissue expander in breast reconstruction: risk of expander rupturing.Anticancer Research. 2016;36(8):4337-4340.Breastcancer.org.Breast implant rupture. Updated October 29, 2020.Suga, H.; Shiraishi, T.; Tsuji, N. et al.Risk factors for complications in expander-based breast reconstruction: Multivariate analysis in Asian patients.Plast Reconstr Surg Glob Open.2017 Nov;5(11):e1563. doi:10.1097/GOX.0000000000001563Suga H, Shiraishi T, Tsuji N, Takushima A.Risk factors for complications in expander-based breast reconstruction: multivariate analysis in Asian patients.Plas Reconstr Surg Glob Open. 2017;5(11):e1563. doi: 10.1097/GOX.0000000000001563Breastcancer.org.Breast implant reconstruction. Updated January 18, 2021.Memorial Sloan Kettering Cancer Center.Breast reconstruction using a tissue expander. Updated October 14, 2020.Breastcancer.org.Infection after breast implant reconstruction.
Fujii T, Yajima R, Kuwano H.Implications of long-term indwelling of tissue expander in breast reconstruction: risk of expander rupturing.Anticancer Research. 2016;36(8):4337-4340.
Breastcancer.org.Breast implant rupture. Updated October 29, 2020.
Suga, H.; Shiraishi, T.; Tsuji, N. et al.Risk factors for complications in expander-based breast reconstruction: Multivariate analysis in Asian patients.Plast Reconstr Surg Glob Open.2017 Nov;5(11):e1563. doi:10.1097/GOX.0000000000001563
Suga H, Shiraishi T, Tsuji N, Takushima A.Risk factors for complications in expander-based breast reconstruction: multivariate analysis in Asian patients.Plas Reconstr Surg Glob Open. 2017;5(11):e1563. doi: 10.1097/GOX.0000000000001563
Breastcancer.org.Breast implant reconstruction. Updated January 18, 2021.
Memorial Sloan Kettering Cancer Center.Breast reconstruction using a tissue expander. Updated October 14, 2020.
Breastcancer.org.Infection after breast implant reconstruction.
Beak, W.; Lew, D.; and Lee, D.A Retrospective Analysis of Ruptured Breast Implants.Arch Plast Surg.2014 Nov;41(6):734-9. doi:10.5999/aps.2014.41.6.734.Payne, R.; Bello, R.; Siotos, C. et al.Abstract: Tissue Expander Failure in Breast Reconstruction.Plast Reconstr Surg Glob Open.2017 Sep;5(9 Suppl):114. doi:10.1097/01.GOX.0000526328.32234.a6.
Beak, W.; Lew, D.; and Lee, D.A Retrospective Analysis of Ruptured Breast Implants.Arch Plast Surg.2014 Nov;41(6):734-9. doi:10.5999/aps.2014.41.6.734.
Payne, R.; Bello, R.; Siotos, C. et al.Abstract: Tissue Expander Failure in Breast Reconstruction.Plast Reconstr Surg Glob Open.2017 Sep;5(9 Suppl):114. doi:10.1097/01.GOX.0000526328.32234.a6.
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