Is it "normal" to have stabbing pains and muscle twinges constantly after having expanders filled 2 months previously?

Question

Surgeon only filled once (said that was enough) but I couldn't move my arms for 2 weeks because of the tightness and pull. I am in constant pain. Now I can feel the plastic beneath my skin (feels like bubble wrap when pressed) Not sure I can last the 8 week wait to have replacements put in.

Jaime S. Schwartz, MD, FACS · Answer

The muscle that is used to cover the expanders, when stretched can be painful. In some cases this may not get better.I have had remove expanders some times because of this and utilize dermal matrix or a flap to complete the reconstruction.For larger breasted women, I have been working on a procedure to spare the muscle entirely due to this pain.The best way to assess and give true advice would an in-person exam.Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.best of luck!Dr Schwartz

Tracy Kayan, MD · Answer

While it is never "normal" to have a lot of pain with expanders in, a lot of patients do complain of discomfort in the armpit area and near the bottom of the sternum (breast bone) which is likely from the expander hitting these areas or internal sutures pulling. Expansion itself rarely causes the pain you are describing, as the purpose of expansion is to SLOWLY put pressure on the skin and muscle. You should bring this issue up with your surgeon to make sure there isn't anything else going on such as infection, although it doesn't sound like it. Sometimes muscle relaxants such as cyclobenzaprine or hydroxizine can help with the muscle tightness and spasms.

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+

Is it "normal" to have stabbing pains and muscle twinges constantly after having expanders filled 2 months previously?

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