Uneven Softness on Breast Tissue Expander

This is normal. The strategy for a tissue expander is to underfill in order to optimize breast tissue perfusion.  Your surgeon will begin to fill the tissue expander soon.

Most tissue expanders have a very rough and irregular texture to their surface. Often times, patients are able to feel these irregularities through their skin. Although some of the irregularities may be inherent to your residual breast skin and tissue envelope, this will likely improve once the expanders are replaced by permanent  implants.

This is quite normal and typically reflects the characteristics of the tissues covering the expander. In some areas it may be muscle which tends to be firm and in the other areas it may be skin and fat which tends to be softer. Some surgeons use skin like subtitutes to provide additional coverage of the lower and inner parts of tne breast which may cause a different sensation as well.
Ask you surgeon and I am sure he will gladly answer your questions.

Expanders have a soft shell and a port through which the implant is located and filled. The "hard part" is the port that is felt through the skin with the soft part usually being the silicone portion of  expander itself. If you have concerns that something is changed, make sure you address it with your plastic surgeon.

Tissue expanders can feel soft until they are filled to the max.  If you are concerned, then I would speak to or see your surgeon

During my consultation with my patients, when discussing tissue expander reconstruction, I describe the tissue expander implants as "under construction" implants.  They will feel irregular and hard.  If you are feeling areas that are soft, it may be that your tissue expanders are underfilled.  Don't worry, your plastic surgeon has the ability to fill your expander up in your office gradually.  This is the normal part of the reconstructive process during implant based reconstruction

The feel of a tissue expander depends on two things:


How much skin/fat/muscle are covering the expander

How full the expander is


The amount of tissue overlying the expander will affect its feel. The more fatty tissue there is, the softer the feel.

Your tissue expanders were filled with 350cc's of saline, but if they are 450cc expanders, they will feel soft. If they are filled to the nominal (amount of saline needed to remove all wrinkles) amount, they will be slightly firm, but compressible. If they are overfilled they will feel quite firm. Also, if they are underfilled, you may notice "points" or folds when you feel the expander. This is normal.

In addition, you may notice the weight of your expanders as they are filled over time. These devices can become quite heavy. This firmness of these devices is important as they must be able to expand the tissues they are placed in. The permanent implants (either saline or silicone) are both lighter and more deformable (softer) then their equivalently filled tissue expanders.

Goryes: We're sorry to hear you had breast cancer and needed reconstruction. I assume you have had the opportunity to talk with your Plastic Surgeon at length.
Tissue expanders are usually placed under thin skin and some muscle. Then they are partially filled initially. The expander itself has a firm disk that is designed for injection to fill it further, and softer pliable fluid-filled bag or shell. Given these factors it would not be unusual for you to feel different amounts of firmness.

There are many factors that may account for what you are experiencing:
1. The expander my not be completely filled after 3 wks.
2 The shape of the epander or its wall construction.
3. The thickness of your tissue in that area.
4.The presence of a fluid collection.
Your surgeon should be able to answer your question.