Moving a breast expander. Will it be possible to move it further down or is it fixed in place?

Question

I had a double mastectomy with expanders one was a delayed from prior mastectomy and one was straight to expander skin sparing. Due to incision opening on the delayed side the expander was removed and replaced through a further surgery. It went back in too high and now I am lopsided . If I keep constant pressure at the top of the expander with a stretchy band will it be possible to move it further down or is it fixed in place? Alternatively will this problem be rectified at exchange surgery?

Gary M. Horndeski, MD · Answer

You can certainly try to move the expander down by using a compressive garment above. However, the alternative is at the time of surgery, the surgeon an extend the pocket inferiorly and correct the problem at that time.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Christine Fisher, MD, FACS · Answer

Thank you for your question.  It is not necessary nor helpful to band an expander.  These are devices that are typically sewn into position on the chest wall to provide appropriate expansion of the skin during your healing phase or any further oncologic treatment needs and thus will not move despite banding attempts.

When the exchange procedure takes place, your surgeon will remove the expander and the sutured tabs allowing for freedom of implant placement within your breast pocket.  As an additional FYI, often during the exchange procedure, there is work done to the capsule pocket that will open areas of unwanted constriction or asymmetry leaving you with very symmetric and soft breasts.  You happen to be within the adjustment and stretch phase and can not focus on symmetry until after your final exchange procedure.  Try to trust your provider and this process.

What is helpful as well is discussing all of your questions and concerns during your next surgical consult as I have faith that your surgeon will work with you and help educate you on how these valid concerns will be addressed and repaired during your exchange procedure.

Tommaso Addona, MD · Answer

Thank you for your question.
Overall, I would not recommend trying to move the expander on your own. Some tissue expanders are sutured into place at the time of surgery, so this may cause you discomfort. At the time of your surgery of replacing the tissue expanders to permanent implant, your surgeon will be able to manipulate the breast pocket to place your implant in a more favorable position. I recommend speaking with your plastic surgeon to discuss your concerns.

Ryan Rebowe, MD · Answer

Depending on how long the expander has been in place, you will likely need to have surgery to lower the implant on the affected side. Operative revision would likely include an internal capsulotomy procedure to open up a space for the implant to slide into. This may be achieved at the exchange surgery in which your permanent implant is placed as this is a common issue in expander based reconstruction. Implant massage or a band is typically utilized after these procedures to help the implant move into its proper orientation.

Daniel Barrett, MD · Answer

Dear laurel7777,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Neil Tanna, MD, FACS · Answer

The key with a tissue expander is proper placement. The goal is to expand the lower pole to create a nice arc. If the expander is superiorly malpositioned it can cause constriction of the lower pole. This is hard to fix at the implant exchange. Unfortunately, its hard to non-surgically move expanders once they are placed.

Moving a breast expander. Will it be possible to move it further down or is it fixed in place?

Answers (6)

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