A horizontal and vertical expandable tissue spacer implants, insertion tools, assembly methods and surgical methods are disclosed. The horizontal expandable tissue spacer implant includes a first lateral member with a first side, a second lateral member with a first side, and an intermediate spacer member. The intermediate spacer member is adapted to cooperatively engage and hold the first side of the first lateral member and the first side of the second lateral member. A vertical expandable tissue spacer implant includes a top member with a bottom surface, a bottom member with a top surface, and an intermediate spacer member with a coupling mechanism. The coupling mechanism cooperatively engages the bottom surface of the top member to the intermediate spacer member and the top surface of the bottom member to the intermediate spacer member.