I have continued nerve pain in my left chest. It's so tight and I continue to be in pain every day - 19 months after

I am so sorry you are dealing with such significant pain.  It is difficult to say without examining you what the underlying problem may be.  Chronic pain following reconstruction is a complicated issue and can be due to several things.  Sometimes we never really find out what the problem is.  If you have a contracture now, that certainly may be the culprit.  Some patients develop pain from the muscle being elevated and find improvement with the reconstruction being moved above the muscle.  There are few patients with no identifiable cause that removal of the reconstruction altogether may be helpful.  I would recommend consultation with a surgeon who is experienced with reconstruction as well as seeing a physical therapist experienced with post-mastectomy pain management. 

Breast pain after chest radiation is rare but can happen.  If the pain is due to cervical spinal issue, you may want to seek the help of a pain intervention doctor in your area.

All forms of breast reconstruction can have complications.  All to often tissue expander breast reconstruction is made to sound very simple.  You case should make everyone more aware.All forms of reconstruction can be complicated to perform safely and effectively.