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After Bilateral Mastectomy, my Expanders Are Excruciating

asked 1 year ago by nflgrrl in Los Angeles, CA
Latest answer by David Finkle, MD
Question viewed 1,623 times
Tags: expander, mastectomy, pain

I Was a 34A at Best. I am afraid my body is too small to accommodate the smallest expanders available, and I am seriously thinking of ending the reconstruction. I should mention that my mastectomy was a little over 3 weeks ago, and we have not yet started filling the expanders.

14 answers to After Bilateral Mastectomy, my Expanders Are Excruciating

Tissue Expander Pain

I am sorry to hear of your pain after tissue expander placement. I can understand your frustration in consideration of ending your reconstruction. I ask that you consider a few points on the subject: 1. You are only 3 weeks out, your pain is going to improve with time 2. Have your surgeon evaluate you frequently to ensure that you do not have an early infection or a retained fluid collection (r your drains still in?) 3. Discuss with your... more

Paul S. Gill, MD
Houston Plastic Surgeon

Submuscular tissue expanders are painful, but a revision can be done for a better cosmetic result, less pain & deformity

The traditional technique of breast reconstruction using implants employs a two-stage technique, whereby a flat tissue expander is first inserted beneath the pectoralis major muscle, slowly (and very painfully) expanded. Later, the temporary tissue expander is removed and a permanent implant is placed. Unfortunately, for most women, this entire process is lengthy and is associated with a significant degree of discomfort! This is why I was tempted to find a better way to do... more

Karen M. Horton, MD
San Francisco Plastic Surgeon

www.drkarenhorton.com

Breast Reconstruction with Tissue Expanders

Breast reconstruction with tissue expanders is a very painful operation. I doubt that there is any way that your body is too small to accommodate the smallest expanders. I don’t think that this is the problem. Creating the pockets for the expanders is what hurts, and now that this has been done, you have been through the worst part. You are probably still experiencing the normal pain expected after surgery. It seems that it is somewhat more severe in your case. I would encourage you... more

Max Polo, MD
Miami Plastic Surgeon

Pain with tissue expansion

Unfortunately, some pain with the tissue expansion process is normal, however, it sounds like your pain is more than is typically expected. You may want to visit with your surgeon to double check that everything is OK and that the pain is not the sign of a problem like a hematoma (which hopefully it is not). In the event that the pain is not the result of a problem, and just your body's response to the tissue expansion, you may want to consider alternate methods of... more

David Greenspun, MD, MSc
New York Plastic Surgeon

www.davidgreenspunmd.com

Improving expander breast reconstruction recovery

Although your symptoms may be entirely normal, I would need more information to advise about your specific case. For example, the traditional approach using the "total submuscular" technique is typically quite painful, and the expansions can be difficult as well. The trend now is to use Alloderm to support the bottom and sides around the expander. This avoids having to dissect up the muscles that are the most tight and painful, while also giving a lot of control over the shape.... more

Richard Baxter, MD
Seattle Plastic Surgeon

Give it some time

I would give it a little more time yet for your pectoralis muscle in the chest to relax after being stretched. This will likely improve in a couple more weeks then you can begin expansion in small increments.

Samer W. Cabbabe, MD
Saint Louis Plastic Surgeon

Pain After Tissue Expander Insertion

It is very normal to be in pain after a tissue expander reconstruction - even 3 weeks out from the insertion. Some people are just more sensiive than others to this type of discomfort. You can ask your surgeon if he can remove some of the fluid that was injected into the expander at the time of your surgery. Also, 4mg valium every 6 hrs as needed is very effective at relieving the musculoskeletal discomfort associated with expanders.

Gary D. Breslow, MD
Paramus Plastic Surgeon

Bilateral Mastectomy, my Expanders Are Excruciating

After mastectomy, breasts can be reconstructed using a variety of methods. In general, techniques use autologous tissue (from your own body), implants, or a combination of the 2. You and your surgeon chose to go with tissue expanders and from the preoperative size of your breasts, it sounds like you needed additional volume and stretching of your skin. You are having pain after surgery. You are frustrated and are thinking about ending the reconstruction. Try to stick with it and... more

Kenneth Bermudez, MD
San Francisco Plastic Surgeon

Post op pain

I am assuming that you underwent a bilateral mastectomy and bilateral immediate reconstruction with tissue expanders. It is not unusual to have pain 3 weeks after the surgery. You may be also experiencing some muscle spasms from the stretching of the pectoralis muscle. Make sure you have adequate pain pills and maybe add a muscle relaxant. If the pain is so severe that it can not be controlled with oral medication, then you might consider removing the expanders. BUT,... more

David Finkle, MD
Omaha Plastic Surgeon

Breast reconstruction works.

Hi. Do not give up! Tell your surgeon to remove some saline from your expanders to make you more comfortable right away. Almost empty expanders should not bother you. Then you can begin getting expanded very slowly. Get re-examined right away. Your degree of pain is unusual, and you should make sure that there isn't some other cause, such as infection or hematoma.

George J. Beraka, MD
Manhattan Plastic Surgeon

Expanders after mastectomy

If you a re just 3 weeks after mastectomy and tissue expansion placment you may certainl yahve discomfort. If it is excruciating you should have it checked out by your surgeon.

Steven Wallach, MD
Manhattan Plastic Surgeon

After Bilateral Mastectomy, my Expanders Are Excruciating

I was the first in MIAMI to use the Radovan expander and Becker expander in the early 1980's, so if you are in such great discomfort or pain I recommend to discuss with your PS to have them removed. Expansion in 95% of the reconstructions is relatively non painful. More of a stretching. I think your pre operative informed consent was lacking in your options. Some mastectomy patients are better suited for delayed reconstruction than immediate. Seek guidance from your surgeons.... more

Darryl J. Blinski, MD
Miami Plastic Surgeon

Pain after first stage breast reconstruction

It sounds as if the pain is unrelated to the expanders since they are currently un-expanded. Certainly the expansion should begin only once you are fully healed and pain-free. The need for expanders is also governed by what your goal is . If you are quite small to begin with, had a skin-sparing type mastectomy, and want to be be relatively small after, then serial implants would have been a possibility. However, placing expanders is a safe choice since they can essentially act as a first... more

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Expanders are not the only option!

If you have skin available, you do not need expanders. Ido almost all my reconstructions in a single stage ,and immediate . I understand your mastectomy already happened. If you have extra skin, you can avoid the expanders with the use of a collagen graft to expand your muscle and place a small memory gel permanent implant. If no skin was saved, and the expanders are painful, the graft can expand the muscle and reduce the skin expansion pain. The other option is a flap reconstruction.Good luck. more