After Bilateral Mastectomy, my Expanders Are Excruciating

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. Hopefully this was done in your case, and things will settle down. Either way it is early and it will get better.

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 not to end the reconstruction. Things should get better soon. Filling the expanders can wait until you are feeling better. In fact, removing some of the fluid placed in the expanders at the initial surgery may relieve some of your discomfort. Another option is to ask your surgeon for a referral to a pain management specialist. There may be some more effective pain medications for you to take. Topical anesthetics or even intercostal nerve blocks may also be of help in getting you through this difficult but temporary phase.

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 see if you can make some adjustments. This is the most difficult time and things will become easier.

A few questions to consider…Did your surgeon fill the tissue expander intra-operatively? Are they submuscular? If yes, then ask your surgeon to deflate the tissue expander and see if that helps. If you are still having pain, then there should be some consideration to changing your tissue expander to a subglandular (above the muscle) location. That should do the trick, but remember, putting the TE above the muscle increases other issues with your implant. Ask your surgeon. Hope this helps, good luck.