I had breast expanders after mastectomy and radiation and have pain.

This is always a difficult situation because of the urgency to perform surgery. I am glad you had an immediate breast reconstruction. As the skin irritation resolves from radiation I hope you can be expanded without pain. If pain persists in the face of expansion then I am concerned about your ability to be pain free when you have your expanders removed and permanent implants placed. This can be the result of scarring or capsule formation around the expanders or in the axilla if node removal was indicated for a positive sentinel node. In any event this is a very complex issue at times. If you have no relief I had ultimately used the lower abdominal tissue in the form of the DIEP flap to fill the space after I remove expanders, the scar or capsule formation around the expanders and any axillary scarring.Three basic forms of breast reconstruction exist. You can use your own tissue, implants or a combination of the previous two techniques. Your own tissue can be used in the form of the DIEP flap, PAP flap, SGAP flap or fat grafting. Implants can be done in one stage or two stage. Two stage reconstructions are started by placing expanders at the time of mastectomy. Once they expanders are placed they are able to be inflated as determined by wound healing. The final time consists of combining any of the above techniques. If you are interested in being seen in Austin please give us a call. I know this is a difficult time for you. The majority of my practice is devoted to reconstruction for women with breast cancer or who are BRCA+

Radiation causes intense inflammatory reaction leading to tissue fibrosis and decreased circulation. with tissue expander there is a higher incidence of capsular contracture and that may be the cause of pain. capsulectomy and reconstruction with a flap can relief the pain caused by radiation and capsular contracture.