Saggy skin with tissue expanders after nipple-sparing mastectomy? (Photo)

Question

Two weeks ago I had a bilateral nipple sparing mastectomy with reconstruction with tissue expanders. They removed 372g from left and 402g from right. The ps was able to fill 300cc in each side of tissue expanders. I am worried about the right side - there is a lot of skin sagging. It wasn't as bad until I went to my first physical therapy session yesterday (not sure if there is a correlation). I have not yet had any subsequent fills. Will this sagging impact the end result? Thanks, LAF

Michael S. Beckenstein, MD · Answer

You have a lot of excess skin that should have been adjusted at the time of the mastectomy. The expanded width and projection is not enough to stretch out the skin. Over filling the expander will not help as the device will become narrower.At the second stage a wider more projecting implant can be used along with a mastopexy to remove any lose skin. This should be only around the areolae which are too wide. This is readily fixable!

Samuel Lin, MD, FACS · Answer

Depending on the location of the pectoralis muscle (most commonly) over the implant loose skin can be adjusted or contoured during the process of breast reconstruction- physical therapy probably didn't cause the loose skin but would check with your plastic surgeon..

Mark A. Brzezienski, MS, MD, FACS · Answer

Be sure to keep your surgeon in the loop with this issue.  It appears that you have a fluid collection around the implant.  If that is the case, an aspiration or seroma catheter placement may be indicated.

Jonathan Zelken, MD · Answer

Dear LAF,
When I see the photo, I agree that there is deformity to your breasts. However, this is in some ways intentional. The point of a tissue expander is to act as an internal placeholder while the overlying skin adjusts to its new environment. Too much tension on the skin could cause it to break down. Sometimes the implant settles out nicely once it gets its first fill. Otherwise, you might need a little revision work during the expander exchange. Bring it up to your plastic surgeon and you can always feel free to seek a second opinion. But for now, your job is to heal! Skin loss is permanent but an imperfect appearance can always be refined by a skilled board-certified plastic surgeon.
Sincerely,

Cain R. Linville, MD, FACS · Answer

No, I don't think you should worry.  The nice thing about expanders is they can be filled out to fill in the skin, and so I don't think you should worry. It won't affect the long term results.

Saggy skin with tissue expanders after nipple-sparing mastectomy? (Photo)

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Answer: Sagging after implant-based reconstruction

Answer: Sagging after implant-based reconstruction

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Saggy skin with tissue expanders after nipple-sparing mastectomy? (Photo)

Answers (7)

Answer: Sagging after implant-based reconstruction

Answer: Sagging after implant-based reconstruction

Answer: Extra skin with expanders

Answer: Extra skin with expanders

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Recommended reading

Everything you need to know about Breast Reconstruction

Our mission is to create a world where every investment in modern beauty is Worth It.