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Objective We present our experience in two-stage procedure immediate breast reconstruction, which aimed to retain local tissue condition for breast reconstruction, overcome the limitation of radiotherapy on implant reconstruction, simplify the procedure as well as improve cosmetic result.Methods The process of our method is divided into two stages.In the first stage, the round-shaped expander was implanted in the subpectoral major space during the procedure of mastectomy.At the same time as expander implanted, the first saline injection was performed.With 4 to 8 weeks of inflation, the tissue expander offered adequate tissue for breast reconstruction.In the second surgical stage, silicon gel implant, latissimus dorsi muscle flap, extended latissimus dorsi muscle flap and deep inferior epigastic perforatior flap were used for breast reconstruction after the tissue expander was exchanged.Results 14 patients have undergone the two-staged breast reconstruction using tissue expansion from June 2004 to December 2007.The average time of therapy was 5.5 month.There were no postoperative complications such as implant exposure, additional scar, flap necrosis.The follow-up time was 6 to 18 month and the result showed excellent contour of the breast at a satisfactory rate 100%.Conclusioins Two-staged tecnhique using tissue expansion in breast reconstruction was easily done and the complications were rare.The technique possesses advantages such as avoiding affection of radiotherapy on silicongel implant and elasticity of skin, retaining maximal local tissue for breast reconstruction.There is no necessary for correction of skin defect and additional scarring, thus the patch-like appearance of breast is avoided.The patients need not experience depression post mastectomy.Two-staged procedure immediate breast reconstruction is a safe and reliable technique which is especially applicable to the cases who need radiotherapy.