How to Repair Muscle Damage Due to Expander Extrusion Post Double Mastectomy?

I am sure you understand that no one can give you definitive advice without seeing you, but if there is an area where there is only skin over the expander then I would advise caution with vigorous exercise. Be sure to discuss the situation with you plastic surgeon. The repair may involve more Alloderm or direct repair of the muscle.

Muscle repair can be performed at the time of implant exchange with an acellular dermal matrix such as alloderm.

If the chest is expanding satisfactorily, then the muscle can be repaired at the time of implant exchange along with the alloderm.

The "BUBBLE" you are feeling is probably the expander either buckled and went throuh the muscle fibers. or just the expander seperated the fibers of the muscle and now you feel it because of thin skin. With excercise you probably seperated the muscle fibers more.

Now repair depend on the examination, if there is buckling of expander and is not flattening with expansion, you may need surgery, becuse the buckled expander edge can erode through the skin.

If it is only seperation of the fibers because the general surgeon who did the mastectomy took out the fascia of the muscle, making it easy for the fibers to seperate, then continue with expansion slowly and at the time of exchange of the expander to the  implantthat seperation can be re-enforced with Alloderm.

If the muscle is that bad and the local skin muscle of the chest is that bad then convert to a latismus dorsi flap or tRAM flap reconstruction.Your plastic surgeon should be able to examine you and discuss your options, and hi/her findings.