Gentle expansion after breast reconstruction should not be painful

Marcia,

You are not crazy. Aggressive expansion can be painful. However, if you do not rush the process and use appropriate medications, such as pain medications and valium, gentle expansion of the muscle/skin envelope does not have to be painful.

Additionally, if your surgeon uses Alloderm or some other dermal substitute during your expander placement, it may be possible to expand more during the initial operation, leaving less expansion to do in the office. Good luck with your surgery.

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Tissue expanders are used for many different purposes in plastic surgery. The most common is for breast reconstruction. In order to fill the tissue expander, a small needle is passed through the skin to the injection port. This port can be part of the tissue expander, or separate from it. Injectable saline (sterile water) is placed inside the expander. This is done until the expansion is slightly uncomfortable but not painful (basically as much as the person can take). I generally tell my patient to take some extra-strength Tylenol or Motrin before coming in for expansion. The process should not be very painful. Hope this helps.

As the tissue is expanded, it can be uncomfortable for some patients. Most tolerate it extremely well. Some patients prefer autologous tissue reconstruction just to avoid these intermittent steps of treatment after expander placement and then subsequent additional surgery for the permanent implant placement.

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