Purpose: We sought to analyze and compare the breast shape produced by a low height tissue expander with that resulting from the use of the full height device.

Methods: We compared the upper pole breast shape in 14 consecutive patients who underwent implant breast reconstruction following tissue expansion. Seven patients underwent expansion with conventional, full height expanders (Group 1) and in 7 patients we used a low height expander (Group 2). Each breast was identically photographed. The superior breast slope line (SBSL) was created by joining the point of upper breast departure from the chest wall (PBD) with the point of maximum breast projection (PMBP). The distance of a perpendicular line drawn from the mid-point of SBSL to the actual breast skin outline defined the superior breast point (SBP).

Results: The mean SBP in the breasts reconstructed using preliminary low height expansion devices was 1.92mm (SD=.416mm) while the mean SBP produced by previous expansion with full height expanders was 3.86mm (SD=.789mm). The SBP in the low height expanded breasts was significantly lower than the full height expanded breasts ( p< .0001).

Conclusions: Our study supports the hypothesis that low height tissue expanders produce a more natural upper pole breast shape.