Should Reconstruction Expanders Move Under the Skin?

Question

I have had my tissue expanders in place since bilateral mastectomy 11/15/10. I stopped getting fills after December 20th so I could heal from my pain, get back to work full time, and spend time with my family. I have noticed that my left implant moves all around under my skin, but the right stays fixed in place and tends to cause much more discomfort, and cramps during times of over-activity with my arms. Is this normal?

Amy T. Bandy, DO, FACS · Answer

Tissue expanders are typically textured, specifically to prevent movement.  However, anytime a pocket is made, there is the potential for movement.  It is unclear from your message whether it is the expander that is moving, or the stable expander that is causing pain.  You should have your operating surgeon evaluate you and consider an ultrasound to determine if you have a seroma around the expander.

David A. Bottger, MD · Answer

Movement of tissue expanders within the surgical implant pocket is not necessarily uncommon. If it occurs it is usually a rotation issue where the more projecting aspect of the expander moves to a different location, creating an asymmetry in breast appearance. The fill ports will then be in completely different locations during subsequent expansion. This can happen with a textured device. Your description suggests that you may have a seroma, or fluid around the expander, which could allow more implant movement. From your time frame it appears you are ready for an implant exchange, at  which point a seroma is evacuated. Some discomfort on the other breast is also possible due to the general stretching of tissues by the expander. Also, a capsular contracture around the implant can produce symptoms. In any case, this is addressed during exchange with your permanent implants. It's always a good idea to have your surgeon assess the situation.

Nia Banks, MD, PhD · Answer

Tissue expanders can move in their pockets under the breast skin. We go through great lengths to prevent this, by anchoring the expanders in place with sutures and using textured expanders. If it is moving, (1) have your surgeon examine you to be sure you do not have a seroma/collection of fluid creating space around the expander. (2) Putting more fluid in the expander can make the expander fit more snugly under your breast skin and keep it from moving so easily.

Robert Brueck, MD · Answer

This probably may be do to some fluid buildup in the side that moves.This is not unusual or cause for alarm.

David Bogue, MD · Answer

The movement of the expander depends on a few issues:

	
		Was the expander sutured in place? Mentor offers expanders with tabs that allow fixation of the expander in the correct position.
	
		Is there a fluid collection around the expander? If a seroma develops, the capsule becomes larger than the expander and you will be able to feel the expander "move" within the pocket


	Often, movement of the expander is easily corrected at the time of exchange to implants. If you have reached your target expansion, I recommend wearing a supportive bra for now and discussing exchange with your surgeon.

Should Reconstruction Expanders Move Under the Skin?

Answers (7)

Answer: Moving expander

Answer: Moving expander

Answer: Expanders are often mobile.

Answer: Expanders are often mobile.

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.

Should Reconstruction Expanders Move Under the Skin?

Answers (7)

Answer: Moving expander

Answer: Moving expander

Answer: Expanders are often mobile.

Answer: Expanders are often mobile.

Browse related questions

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.