Tissue expanders (TE) have played a significant role in reconstructive surgery since their invention in 1956. Initially pioneered by German surgeon Dr. Neumann, the early versions of tissue expanders were made of latex or rubber and served as simple inflatable devices designed to gradually stretch skin and subcutaneous tissue. This technique has since proven to be a critical tool in the reconstructive surgeon’s armamentarium, especially post trauma or mastectomy. Since its conception, expanders have evolved with technology in materials, preventing degradation and risk of irritation. TE are now predominantly made from silicone which is a more biocompatible and durable material. Silicone expanders offered greater flexibility, reduced irritation, and longer-lasting results. In the 1980s, polyurethane coatings were added to prevent complications such as capsular contracture and reduce expander migration. Further innovations included the refinement of inflation systems, allowing for more controlled and gradual tissue expansion. In recent years, advances in hydrogel technology and automated inflation systems have enabled even more precise and comfortable expansion processes. A variation is the Becker expander-implant double lumen two chamber system (inner chamber filled with saline and outer chamber prefilled with gel), which can function as an expander to create the skin expansion necessary and also act as a permanent breast implant once the expansion is completed. Today, tissue expanders are used not only for breast and skin reconstruction but also in cosmetic and craniofacial procedures. They represent a major advancement in the ability to restore or enhance natural body contours.