Although there is nothing wrong with keeping your tissue expander indefinitely, I think you will feel much better after your tissue expander has been removed and you have a softer silicone gel implant placed. This implant exchange procedure is usually a pretty quick procedure and the recovery is relatively very benign. If you are not satisified with implant reconstruction, you may consider a procedure like a DIEP flap using your own tissue. Wishing you a speedy recovery.
Breast reconstruction with implants, breast reconstruction with DIEP flap, TMG flap, SGAP flap falp
No breast implant is a permanent device. I wish you had a better experience. There are ways to do reconstruction that don't involve implants if it is the implant which is the issue. Using your own tissue can be a more natural way of reconstruction that may appeal to you at this point.
Can Expander Stay in Indefinitely?
Expanders are implants, so theoretically they can stay in indefinitely. Usually patients are anxious to get them out for the permanent implants which are softer and more comfortable. Also note that depending on the type of expander you have, your expander may have a metal plate within the port. This could potentially hamper any attempts at an MRI if needed in the future.
While you did not state whether the tissue expander was placed at the time of the mastectomy or afterwards, it sounds as you are worried about experiencing the same pain and discomfort as with your first surgery. Typically the second surgery to place the permanent implant is not anywhere near as painful. This is mainly due to the fact that the dissection and the stretching of the pocket has already been done. In the follow up surgery the surgeon is incising through the previous scar to get to the tissue expander pocket and then exchanging it with the permanent implant.
Expander stay in Forever?
A consult with your surgeon will give you the best choice. Most patients are begging for expanders to be removed or exchanged for implants because they are so hard and firm. Being that said, I do not see why you could not have them for as long as regular implants as long as they do not hurt you.
Only your plastic surgeon can advise you about leaving the expander in. It depends on the coverage of the expander and the thickness of the skin and type of expander.