My body rejected one of my expanders. Should I have the other one removed? Should I postpone the start of chemo?

Question

I had a bilateral mastectomy 4 was ago. My left breast sutures opened up & began leaking fluids. My dr. Could see the expander and said it needs to be removed. Before this happened the same breast was bruised at the top/side and the skin was thin. He recommended removing the expander. What are the chances of my body rejecting the other expander and should I have it removed at the same time. I have not started chemo treatment yet and if nessary want it done before chemo.

Ram Kalus, MD, FACS · Answer

Sorry to learn of your complication. It sounds as though your plastic surgeon is treating you correctly. I would proceed with your oncologist treatment plan and follow your team's advice. To avoid significant asymmetry you may choose to delay expansion on your remaining expander for the time being, but this can also be overcome with external prostheses or bra fillers on your (as of yet) unreconstructed side. There is no reason to remove your healed expander unless you have decided to abandon implant based reconstruction altogether, which would not necessarily be my advice without more information.Please discuss all of your concerns with your plastic surgeon and oncologist, but I recommend avoiding any more delays with your oncologic treatment. Best of luck to you.

Anthony Deboni, MD · Answer

Thank you for your question. I am sorry you are having problems. Your left expander needed to be removed because of exposure. This was likely due to healing problems or infection and not true "rejection." Unfortunately, mastectomy does leave the skin somewhat compromised and there is a significantly higher chance of implant problems after mastectomy as compared to breast augmentation. If the other expander is not having problems, I would recommend you leave it in place in continue with your chemotherapy. After your treatment is completed, an expander can be replaced on the left side and you can continue with your reconstruction. Best of luck and best regards.

Steven Wallach, MD · Answer

Sometimes expanders get exposed or infected. If the other side is ok, then it does not have to be removed.  Best of luck.

Sara Yegiyants, MD, FACS · Answer

Sounds like the mastectomy flap didn't have sufficient blood flow for healing. This doesn't mean your body is rejecting the expander. The options are to remove the exposed expander or salvage the reconstruction by revising that side. Check with your plastic surgeon and your oncologist with regards to the best approach given your need for chemotherapy. The uninvolved side doesn't need to be removed. Best, Dr. Yegiyants

My body rejected one of my expanders. Should I have the other one removed? Should I postpone the start of chemo?

Answers (4)