Should Reconstruction Expanders Move Under the Skin?

I have had my tissue expanders in place since bilateral mastectomy 11/15/10. I stopped getting fills after December 20th so I could heal from my pain, get back to work full time, and spend time with my family. I have noticed that my left implant moves all around under my skin, but the right stays fixed in place and tends to cause much more discomfort, and cramps during times of over-activity with my arms. Is this normal?

Doctor Answers (7)

Moving expander

+1

This probably may be do to some fluid buildup in the side that moves.This is not unusual or cause for alarm.


Fort Myers Plastic Surgeon
5.0 out of 5 stars 19 reviews

Expanders are often mobile.

+1

The movement of the expander depends on a few issues:

  • Was the expander sutured in place? Mentor offers expanders with tabs that allow fixation of the expander in the correct position.
  • Is there a fluid collection around the expander? If a seroma develops, the capsule becomes larger than the expander and you will be able to feel the expander "move" within the pocket

Often, movement of the expander is easily corrected at the time of exchange to implants. If you have reached your target expansion, I recommend wearing a supportive bra for now and discussing exchange with your surgeon.

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 12 reviews

Should Reconstruction Expanders Move Under the Skin?

+1

Sorry for your issues. Sounds like the right is undergoing a capsular fibrosis formation. Seek the input from your PS. This is my opinion based upon the pain and non movement as you describe. From MIAMI 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 62 reviews

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Should Reconstruction Expanders Move Under the Skin?

+1

Tissue expanders are typically textured, specifically to prevent movement.  However, anytime a pocket is made, there is the potential for movement.  It is unclear from your message whether it is the expander that is moving, or the stable expander that is causing pain.  You should have your operating surgeon evaluate you and consider an ultrasound to determine if you have a seroma around the expander.

Amy T. Bandy, DO, FACS
Newport Beach Plastic Surgeon
5.0 out of 5 stars 85 reviews

Moving expanders and breast pain

+1

Movement of tissue expanders within the surgical implant pocket is not necessarily uncommon. If it occurs it is usually a rotation issue where the more projecting aspect of the expander moves to a different location, creating an asymmetry in breast appearance. The fill ports will then be in completely different locations during subsequent expansion. This can happen with a textured device. Your description suggests that you may have a seroma, or fluid around the expander, which could allow more implant movement. From your time frame it appears you are ready for an implant exchange, at  which point a seroma is evacuated. Some discomfort on the other breast is also possible due to the general stretching of tissues by the expander. Also, a capsular contracture around the implant can produce symptoms. In any case, this is addressed during exchange with your permanent implants. It's always a good idea to have your surgeon assess the situation.

David A. Bottger, MD
Philadelphia Plastic Surgeon
5.0 out of 5 stars 26 reviews

Tissue expander moving

+1

Tissue expanders can move in their pockets under the breast skin. We go through great lengths to prevent this, by anchoring the expanders in place with sutures and using textured expanders. If it is moving, (1) have your surgeon examine you to be sure you do not have a seroma/collection of fluid creating space around the expander. (2) Putting more fluid in the expander can make the expander fit more snugly under your breast skin and keep it from moving so easily.

Nia Banks, MD, PhD
Washington Plastic Surgeon
4.5 out of 5 stars 16 reviews

Expanders

+1

Usually expanders are textured so that they do not move around too much.  Not all tissue expanders behave as they are supposed to.  If you have concerns, you should speak with your surgeon.  Good luck.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

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.