Were the wrong size tissue expanders put in?

Question

I recently had a bilateral skin and nipple sparing masectomy with tissue expanders put in place. I did emphasise to my surgeon I would like to be a D cup eventually. Previously I was a B to a small C cup. I am 66 kg and 164 cm tall. The tissue expanders put in go up to 450 cc. But after reviewing pictures I am worried this size won't give me a size D. What size will this give me. Can I still get to a D.

Lewis Albert Andres, MD · Answer

Thank you for your question!  Most surgeons choose the tissue expander based on your base width of your chest wall.  Tissue expanders can certainly be overexpanded past the noted fill volume.  Regardless, your surgeon will likely expand you until you are happy with the desired size, and then subsequently exchange these expanders for comparable size implants.  I would discuss your goals and expectations with your surgeon, if you haven't done so already.  Continuing with the process is reasonable and do not be caught up on the volume alone.  Other modalities following your procedure may be for fat grafting or revision to get you to your desired goals.

Kendall Roehl, MD, FACS · Answer

Most reconstructive surgeons chose tissue expander size based on the width of the tissue expander and your breast/chest wall. The manufacturer's recommended volume of 450cc is not an absolute and often expanders are over-inflated. This allows ample volume to be injected to reach a desired cup size without the unwanted width to the reconstructed breast from a larger expander. It is also hard to estimate cup size as a general rule based on CC volume alone. The appearance of 450cc on a small petite woman is very different than 450cc on a larger framed woman. Only your doctor can give you a realistic picture of the final outcome.I am sure you discussed ultimate size with your surgeon, but you should always voice your concerns.

Robert Whitfield, MD · Answer

As mentioned below it depends on your measurements for the base width that will fit your chest properly.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
time consists of combining any of the above techniques.

If
you are interested in being seen in Austin 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+

Steven M. Camp, MD · Answer

Thanks for sharing your question.It is still early after surgery and your expander can be inflated more.  When choosing an expander multiple factors are important to consider, including width and projection.  Sometimes an expander with variable or lower height is selected and in these cases the volume that the expander can be exceeded above the listed volume, so called "over-expanding".  Visit with your plastic surgeon and share your concerns, I am sure there is a good reason for the expander selected.Best Wishes.

Were the wrong size tissue expanders put in?

Answers (4)

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