■ As a staged approach, involving some reconstructive surgery during mastectomy or lumpectomy and more reconstructive surgery after any additional treatments. This is also called delayed-immediate reconstruction . In delayed-immediate reconstruction, a tissue expander is inserted under the chest muscle and preserved breast skin after the breast is removed. Temporarily placing an expander or implant will preserve the shape of the breast and breast skin during the upcoming radiation treatments and allow for the final benefit of a skin-sparing mastectomy technique. A tissue expander is a balloon-type device that stretches the skin to create a “pocket” for the reconstructed breast under the skin. Once radiation is complete and tissues have recovered (4-6 months), the expander/implant that was used to maintain the shape of the breast is removed and replaced with a flap from the proper donor site as decided upon in consultation with your surgeon.