I had a double mastectomy in August 2005. I still have tissue expanders in due to a series of events that made it impossible to get to and from appointments. Has anyone had this experience or heard of this (expanders being left in so long)? Is it likely that there is mold growth inside of my expanders because of the length of time they have been in?
Mold Inside Tissue Expanders?
Doctor Answers 8
Expanders in for 3 1/2 years.
Since your expanders were placed in 2005 I hope you were able to complete expansion. If not, you may be well served by additional surgery to create more favorable pockets followed by routine tissue expansion. The most significant issue with having the expanders in so long is the inability to take advantage of laxity of the skin that may have present right after mastectomy. Now the situation may be more like delayed rather than immediate breast reconstruction.
If you have additional surgery, your surgeon could evaluate your current expanders or perhaps replace them at that time. Then you could go on to complete your breast reconstruction.
The rare possibility of mold or fungal growth would be present with an implant or expander, but it would be unlikely.
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You are likely OK from the mold perspective
Tissue expanders are really a specialized breast implant. What is important for you to know is that they are made to the same sterility standards as regular implants. Regular implants should not have mold in them, neither should your expanders.
I would recommend that you go back in the near future to complete your care. Just commit to doing it, no more excuses, just do it. You will feel relieved that you did.
Mold and expanders
Unlikely it is not mold because the expanders are technically placed under sterile conditions. You could have scar tissue and I have also seen a "slime layer" when they in for a long time. Either way, they should be removed, the capsule partially excised and either expanded to size or a new implant placed if there is no signs of infection.
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If you have had expanders in for a long time, you will more than likely need them removed to complete your reconstruction. If they have not been expanded enough, you may need new expanders and the pocket opened to accomodate the expansion.
Expanders Left In....
It is unlikely that you have mold in there, but you probably have a bit of scar tissue especially if you had chemotherapy, radiotherapy or if you smoke. You might require more than simple expander removal and implant placement.
John Di Saia MD
Mold contamination of implants
I have had paitent's "disappear" with expanders (in place) due to varying reasons. Once came back 18 months after it ruptured.
There are also combination expander/implants that are meant to stay in that long. However, it is more likely that your surgeon would have told you.
Generally there no immediate risks to leaving the implants in place.
In regards to mold, that did occur in the past. It was attributed to spore like contamination of the saline that sat on the back table and was used to fill the implants. Currently we use a completley different filling system which is called clased. This greatly reduced the rate of mold colonization of the implant
Mold in tissue expanders highly unlikely
There are sporadic reports of fungus in implants/expanders, but these are the result of contamination of the saline instilled in the devices. The time an implant spends in the body has no effect on probability of infection, especially fungal types.
While there have been anecdotal reports of fungus and mold growing in implants, it is very rare. It is a good thing that expanders can be used as long-term implants if necessary, but if they were not intend as such by your surgeons, you such consider having regular saline or silicone gel implants placed soon.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.