The first step of the process involves inserting a tissue expander (temporary implant spacer) that allows acute healing of the skin and expansion of the expander once the skin has healed. The primary benefit to a two-staged approach is a) to allow healing of the skin envelope before putting additional stress from the weight of an implant; b) oncologic evaluation of the surgical specimen and, if needed, an immediate-delayed reconstruction based on the need for adjuvant therapies (chemo/radiation).