Post-mastectomy breast reconstruction using tissue expanders is a widely adopted technique that relies on controlled mechanical stretching of skin and soft tissues to facilitate neo-tissue formation. This study presents a computational modeling framework to simulate skin behavior and tissue growth during the expansion process. Utilizing a finite element approach combined with growth algorithms, the model accounts for the skin’s nonlinear anisotropic properties, mechanical adaptation, and the biological response of surrounding tissues. The simulation results demonstrate key insights into stress distribution, tissue strain patterns, and rates of neo-tissue generation, which closely align with observed clinical outcomes. By validating the model against empirical data, the study offers predictive capabilities for optimizing expander design, placement, and inflation protocols. This computational strategy not only enhances the understanding of tissue mechanics in reconstructive surgery but also supports personalized surgical planning for improved aesthetic and functional results.

Computational Modeling, Skin Biomechanics, Tissue Expansion

American Cancer Society, 2024, “How Common Is Breast Cancer?,” American Cancer Society, Atlanta, GA, accessed Apr. 16, 2025, https://www.cancer.org/cancer/types/breast-cancer/about/how-common-is-breast-cancer.html

Kummerow, K. L., Du, L., Penson, D. F., Shyr, Y., and Hooks, M. A., 2015, “Nationwide Trends in Mastectomy for Early-Stage Breast Cancer,” JAMA Surg., 150(1), pp. 9–16.10.1001/jamasurg.2014.2895

Miller, K. D., Nogueira, L., Mariotto, A. B., Rowland, J. H., Yabroff, K. R., Alfano, C. M., Jemal, A., Kramer, J. L., and Siegel, R. L., 2019, “Cancer Treatment and Survivorship Statistics, 2019,” CA: Cancer J. Clin., 69(5), pp. 363–385.10.3322/caac.21565

Marcus, J., Horan, D. B., and Robinson, J. K., 1990, “Tissue Expansion: Past, Present, and Future,” J. Am. Acad. Dermatol., 23(5), pp. 813–825.10.1016/0190-9622(90)70296-T

Bertozzi, N., Pesce, M., Santi, P., and Raposio, E., 2017, “Tissue Expansion for Breast Reconstruction: Methods and Techniques,” Ann. Med. Surg., 21, pp. 34–44.10.1016/j.amsu.2017.07.048

Johnson, T. M., Lowe, L., Brown, M. D., Sullivan, M. J., and Nelson, B. R., 1993, “Histology and Physiology of Tissue Expansion,” J. Dermatol. Surg. Oncol., 19(12), pp. 1074–1078.10.1111/j.1524-4725.1993.tb01002.x

Kidd, T., Mccabe, G., Tait, J., and Kulkarni, D., 2024, “Implant Reconstruction After Mastectomy—A Review and Summary of Current Literature,” Cancer Treat. Res. Commun., 40, p. 100821.10.1016/j.ctarc.2024.100821

Xie, Y., Tang, Y., and Wehby, G. L., 2015, “Federal Health Coverage Mandates and Health Care Utilization: The Case of the Women's Health and Cancer Rights Act and Use of Breast Reconstruction Surgery,” J. Women's Health, 24(8), pp. 655–662.10.1089/jwh.2014.5057

Elder, E. E., Brandberg, Y., Björklund, T., Rylander, R., Lagergren, J., Jurell, G., Wickman, M., and Sandelin, K., 2005, “Quality of Life and Patient Satisfaction in Breast Cancer Patients After Immediate Breast Reconstruction: A Prospective Study,” Breast, 14(3), pp. 201–208.10.1016/j.breast.2004.10.008

Jonczyk, M. M., Jean, J., Graham, R., and Chatterjee, A., 2019, “Surgical Trends in Breast Cancer: A Rise in Novel Operative Treatment Options Over a 12 Year Analysis,” Breast Cancer Res. Treat., 173(2), pp. 267–274.10.1007/s10549-018-5018-1

Browne, J. P., Jeevan, R., Gulliver-Clarke, C., Pereira, J., Caddy, C. M., and van der Meulen, J. H. P., 2017, “The Association Between Complications and Quality of Life After Mastectomy and Breast Reconstruction for Breast Cancer,” Cancer, 123(18), pp. 3460–3467.10.1002/cncr.30788