3 Weeks Post Mastectomy - Should I be Able to Have my Expander Filled?

I had a mastectomy 3 weeks ago. I was suppose to have my first fill to my expander. My doctor chose not too. I had dead skin and she had to cut it away and add a couple stitches. I was wondering if this is normal?

Answers (7)

Tissue expansion and necrotic skin

If you have some skin necrosis requiring a minor revision, then your surgeon made a wise choice not to begin expansion until this problem has had a chance to recover. While it is not normal to have skin flap necrosis after mastectomy, it is also unfortunately not rare. About 10 % of patients will experience at least a minor amount of this. If your surgeon was able to correct this with a few stitches, then it was a minor amount.

Columbus Plastic Surgeon

Tissue Expanders

It sounds like you had necrosis of the skin flaps, which can happen after immediate reconstruction following mastectomy.  After removing the skin at the second procedure, it may be necessary to wait longer for the first expansion.

Jeff Scott, MD
Everett Plastic Surgeon

Tissue expansion and necrotic skin

Sometimes when expanders are placed, what looks like decent skin flaps turns out sometimes are not. This can lead to necrotic skin which requires debridement and reclosure. Waiting for things to heal is the right approach before expanding the skin.

Steven Wallach, MD
Steven Wallach, MD
New York Plastic Surgeon
30 reviews

Serial expansion following expander placement

you can start expansion of your expander approximately two weeks following healing. Thus, if you have no skin compromise, you can start at two weeks following surgery. If your surgeon had to revise your skin, then wait two weeks until your skin has healled prior to initiating expansion.

No rush to fill expanders if healing is delayed

If there are no problems with healing then the expanders may begin to be filled as early as 2 weeks, but if there is any problem with healing then this will put too much pressure on the skin flaps. Occasionally it is helpful to remove some fluid to relieve pressure but this is uncommon. It sounds like you are in good hands so be patient.

Richard Baxter, MD
Richard Baxter, MD
Seattle Plastic Surgeon
63 reviews

When to start expansion?

I like to start expansion at 2 weeks, but if there are wound healing problems such as yours, I would delay it too.

Breast Reconstruction

You have trusted your surgeon to do a very complex reconstruction procedure. You need to trust him/her id the decision to when to expand. You have problem with skin healing (loss of skin) which will delay the expansion process till all healing have occured and is safe to expand.Expansion will put presure on the healing process theefore all wounds and skin mist e stable and safe to expand. We do not know what type of mastectomy you had and if radiation was administeed. These will delay the expansion process. Seek all explanations from your doctor, reasons and what is the thinking now.

Samir Shureih, MD
Baltimore Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.

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