Sometimes immediate reconstruction is not recommended or not possible, usually because of the type of tumour or because the patient needs further treatments such as radiotherapy.
In such cases, a secondary reconstruction is performed. It requires several steps. Firstly, the skin must be expanded using a tissue expander. A tissue expander is a special type of temporary implant that is inserted unfilled, and is then filled with saline solution via a remote or an integrated valve over the course of several weeks, to slowly expand the skin until there is enough tissue to insert a permanent implant. Then, the expander is replaced with the permanent implant in the desired size.
The variety of implant shapes available today makes it possible to achieve a very natural look.