How do I relieve the chest tightness felt post bilateral mastectomy with tissue expanders placed at the time of surgery?

Question

Two weeks ago I had a bilateral Mastectomy with bilateral tissue expanders placed to start the reconstruction process. I am on antibiotics. My chest is so tight that I don't sleep much and am always aware of the surgical site. I will not undergo radiation. I will start chemotherapy in three weeks.

Allen Gabriel, MD, FACS · Answer

Thank your for your question. What you are experiencing is very common after breast reconstruction with placement of expanders under the muscle.  Ask for a referral to physical therapy as it is very important for you to start improving your range of motion and having a good posture.  This will help you tremendously.  You can also ask for prescription of Valium as a muscle relaxant which will make you sleepy.  You can also ask your plastic surgeon to inject Botox directly into tail of your pectoralis Muscle.  This is towards your armpit and can directly be injected. You would have to buy the Botox from your plasti surgeon so he can inject it.  The Botox will relax the muscle for 3 months with no side effects.  This has worked extremely well for my patients.  Best of luck.

Robert Whitfield, MD · Answer

It has been my experience over the
past 10 years that the tight band pain that can be experienced by patients with
expanders in place does't get relieved by exchange to permanent implants in
each case.  In many instances the constant pressure or tightness remains.
 I have removed these expanders in many patients referred to me and one of
my own patients recently.  I have successfully performed reconstruction
with their lower abdominal tissue, the DIEP flap or PAP flap, and they all have
recovered well without that sensation of pressure or tightness.

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 type consists of combining
any of the above techniques.

If you are interested in being seen
in Austin, Georgetown or New Braunfels 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+

William A. Terranova, MD (retired) · Answer

Much of the tightness you are feeling is due to the expanders and post operative swelling.  As the swelling resolves and the tissues stretch, the tightness will improve.  In addition, your expanders were placed under the chest wall muscle and so there is some degree of muscle spasm which is also contributing to your symptoms.  A muscle relaxer mau help, but you will need a prescription for that.  Good luck with your upcoming chemotherapy and you future surgeries.

How do I relieve the chest tightness felt post bilateral mastectomy with tissue expanders placed at the time of surgery?

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How do I relieve the chest tightness felt post bilateral mastectomy with tissue expanders placed at the time of surgery?

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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.