Tissue Expander

Question: Do they allow a 2nd tissue expander to continue expanding breast area for reconstructive surgery? They were not able to expand my tissue to be as large as my other breast and I would prefer not to have to have a drastic reduction. Can a 2nd expander be used to create a larger breast cavity before completing reconstructive surgery with implant? This would necessitate an additional surgery, however, and I wanted to know if there was any history of this having been accepted. If anyone else experienced this and found a solution besides a drastic breast reduction on the other side, I'd be greatly appreciative to find out any other options? Because I have Fibromyalgia, which is a conntective tissue disease, I can't do any of the "flaps". I can only use saline implants after having been expanded. Thanks... Yes they put in the tissue expander after a radical mastectomy. I think my original Plastic Surgeon (who was a man) wasn't concerned about my feelings or input (hense my "original Plastic Surgeon"), and didn't expand it as much as he should have prior to my radiation treatments; which caused a lot of scar tissue so it wasn't able to be expanded as much afterward. 3 times I was given 100 cc's of saline prior to the radiation; but I had plenty of time and opportunity to do more, I just wasn't aware that I should have. My new PS was only able to get 2 fillings of 50 cc's each time afterward; which were quite painful, but now everything is fine and my muscles and tendons, etc. have no problem. But she now says I will need a breast reduction on my left side, as well as a lift, to match the right side, because I am over expanded at this time. And, even at the expantion that I have now, once the expander is removed, the tissues actually shrink a bit and I'll be smaller yet. Any suggestions?

Answer: Hi, Sorry that you are having so many problems after surgery; while I am a man, had a couple of things - i understand this is a HUGE issue after surgery (have a couple of friends who have gone through it) as becky said - how about an inplant over the muscle? if that isn't going to work, there are a lot of prostetics out there that could be fitted so both breast match. when i was "young", a good friend of mine worked in this business - local company that specilized in "after surgery bras" etc. fitted correctly, you could not tell the difference. one link http://www.parkmastectomy.com/ this doesn "help", if you are "sans clothes" but any person who loves you will not care if they are not "a set" [ and btw i have never seen a set that were 100% identical anyway]. If they do care, probably not someone you want to be with anyway. hope it was of some help, you might calll the local ACS to get more information: www.cancer.org Jewells 29 months and still here

Question: Anyone experience chemotherapy after mastectomy and tissue expander? I had uni-mast with tissue expander on May 2. Just started first round of chemo and handled all the side effects fine. But I am having a lot of pain where the expander is and wonder if this is normal and why it would be painful again. It is not in the sternum which is expected with the neulasta. (I did have that).

Answer: I had that. Ask the doctor. When they put in saline each time, I was very sore. If this is different, call the doctor and explain what you are going through.

Question: What should I exdpect from tissue expanders after a double masectomy? I had surgery 18 days ago and am extremely uncomfortable from the expanders....feel very very tight and it is extremely uncomfortable. Is this normal and will it subside over time?

Answer: I know how you feel. I was in your same situation. At first, I didn't want reconstructive surgery, but then I also didn't want to wear those heavy prosthetics either. I went to see a Dr who specializes in reconstructive surgery for breast patients only. He was and is considered the best in my area. There were many plastic surgeons around and I chose him. He gave me a huge amount of information on it and what scared me the most was that first step of tissue expander's. Because of my age, that was 62 at the time, he told me if I was younger, it would be easier for me. He wasn't trying to insult me and he made that perfectly clear. We spoke with my husband present for over an hour. He didn't try to rush me, he wanted to explain everything and wanted me to really think about it. I don't know how old you are, but he told me and also through my reading, expanding the tissue is very painful. They start out with putting a small saline filled balloon, so to speak, under the skin. Every so often, it's enlarged with more saline to expand the tissue. The process is long. It's more than just a few weeks of this. It all depends on what size you want for breast as to how much tissue has to be stretched out. You know this tissue is what will go over the muscles used from your abdomen to cover it. Before I say anything more, I really don't want to discourage you. It's only been such a short time for you that's why it's uncomfortable. I have to give you a lot of credit. I just realized you already have the expanders in and you only had surgery 18 days ago? You are brave. How did you pull that off so soon? For me, it's the pain issue. It's going to feel tight, it has to, it's stretching your skin right now beyond what it's used to. You read the first part of my answer as far as how expanders work and this still hold true. They have to stretch it and it will hurt. You have to make sure there is not a build up of fluid under you skin. Well, I'm hoping your Dr will see it if that happens. I had a lot of fluid build up after surgery and it had to be drained. It's normal for a lot. it's normal too that you will feel this tightness and being uncomfortable and yes, it will subside over time, but remember, depending on how large you want your breast, will determine how much skin has to be stretched. God bless you. I couldn't do it. I chickened out. So what am I doing?...just what I didn't want to do, wearing those clumsy, awkward, prosthetics. I hate them. When I'm home, it boobless for me until I have to go out. Ugh. Good luck to you. I wish you the best. You've already gotten over the biggest hump I think. If this is what you want and obviously it is, then I wish you the best. Just think of the end results. My niece did it and she's happy. We women have to go through a lot of discomfort for the sake of vanity don't we? Oh well,

Question: What to expect after a breast tissue expander exchange?PLEASE HELP? My friend just got implants and she is very upset. because of breast cancer she got a double mastectomy and had expanders put in. Today she got her expanders taken out and implants put in. she was so excited but now is disappointed and very saddened by the results because number 1-she thinks they are too small and look like pancakes 2- in the right breast there is some kind of dent or something. my question is, is it normal for the breasts to look like that? how long until a change? will they get bigger? will those things go away and look normal or is there any other solution?

Answer: These are questions for her surgeon. They will not get bigger, the whole idea of a double mastectomy is that all the breast tissue is removed, so there is nothing there to grow. The only way to increase the size is to get bigger implants.

Question: What to expect after a breast tissue expander exchange?she isreally upset!!!? My friend just got implants and she is very upset. because of breast cancer she got a double mastectomy and had expanders put in. Today she got her expanders taken out and implants put in. she was so excited but now is disappointed and very saddened by the results because number 1-she thinks they are too small and look like pancakes 2- in the right breast there is some kind of dent or something. my question is, is it normal for the breasts to look like that? how long until a change? will they get bigger? will those things go away and look normal or is there any other solution?

Answer: When you first get implants, they are normally A LOT more swollen then how they will eventually look due to the intrusive nature of an operation. So it does not sound good that they are too small. as she would have had a consultation discussing the size she wanted the implants. And as for dents, there should be NO dents in the breast. She will need to go and speak to the surgeon who she had the surgery with, however my advice to her would be not to keep allowing the same surgeon to mess up as she will end up with more scarring, it might be more expensive and generally a bit of a hassle going else where but the results should be worth it eventually i wish her the best ~x~

Question: surgery of double mastectomy with tissue expanders how long recovery and will i need a nurse when i come home?

Answer: The recovery can be at about 8 weeks total (had to do some reading on all this before my mom had her mastectomy last year although it was a single one but she was considering double mastectomy). As for the nurse she will come for about 3 or 4 weeks to do the drains and she will also probably teach you how to drain the drains in between times that she comes in. If you have other questions for me please feel free to e-mail me off site any time.

Question: What is a strong long lasting pain relief? My husband had a high pressure injection injury, to his right palm. His hand and forearm filled with asphalt aluminum paint. He has had several surgeries, his latest being reconsturction. He has tissue expanders in his forearm. The first 2 put in leaked, and has been removed and replaced at three weeks after the first 2. Morphine, Demerol, and percocets make him sick. Dilidud help but only for 2 hours, Hydrocodone doesn't touch the pain. Can anyone help me to know what to ask the doctor for?

Answer: Percocet or Vicodin should do the trick, if it upsets his stomach, take them with food. I don't think that Tylenol with codeine will help either, but it might keep him from getting sick, and tolerate the pain without using the hard stuff. How about a muscle relaxer like Soma, that will help, but it will make him sleepy, which may be good for him. You may try rubbing some Aspercreme Cream to on the areas near the pain, but not on any part that is open, put it like on the top of the hand or far side of the arm. I hope for you and your husband the very best, and you deserve a pat on the back for the loving care and concern you have for him. Good Luck

Question: Recover time with breast reconstruction? I would like to hear from women who have had a tissue expander inserted under raidiated breast tissue after mastecotmy. How look was recovery time? How painful was this and what did your breast look like compared to the other breast. Any women had reconsrtuictive breast surgery usuing tissue from the back?

Answer: Check out http://www.breasthealthonline.org There is a forum for those who have had reconstructions.

Question: Will You have Drains with Breast Implant Surgery? I was wondering about the recovery time with breast implant surgery. I have saline tissue expanders in already and next week they will switch them out for the permanant saline implants. My Dr. said the surgery was simple but i don't know if i will have drains or not. Having the drains connected to you makes it uncomfortable and the recovery is longer because i cannot leave the house! Please let me know if you know!

Answer: Many times drain placement varies by the surgeon for most procedures. Your surgeon would be best able to answer that.

Question: Is it ok that my expander for my braces is poking into my gums? I had an expander bar put in my mouth at the end of January. Not an RPE, bu t just a regular metal bar that sits in my mouth. It's definitely working, as my mouth has gotten bigger, but as a result the left side of it where the spring is on the expander is now poking into the roof of my mouth-and it's very painful! The other side is fine-it's resting right above the teeth, but it isn't poking whatsoever into my gums and tissue. So is it normal for the expander to push that far into the top of my mouth? It's actually left a dent in the top of my mouth and it's pushing some of the tissue next to it between a crack in my teeth. I have an appointment booked for next week with the ortho, but I'm trying to find out whether i need to try and bump that up to next week. Any advice would be appreciated!

Answer: get that appointment bumped up. i had my bracket and wires rubbing my cheek, and it left an open flap of skin that had to be cut out. i don't think it would be much fun to deal with more than that. good to get it fixed now. tell them, and they should have a fix for you. wow, i have to say, widening your mouth? ive never heard of it!

Question: Breast reconstruction after mastectomy and complications? About a month ago I had a mastectomy performed on my right breast and a tissue expander placed because the plan was to have an implant reconstruction. About 2 weeks after the mastectomy I developed a severe staph infection in the surgical site. This resulted in an additional surgery to remove the expander implant and close the breast site back up. I was in the hospital for 4 days on IV antibiotics and back home for a week on oral antibiotics to kill the infection. Now it appears that the infection is gone. But we have to start over sometime soon on the reconstruction. Because of the complications it is riskier for me to now do the same reconstruction I had planned (expander and implant). My options are to do the TRAM flap (tummy muscle and tissue) or the flap procedure where they take muscle, tissue and skin from the back. I can do the back flap with or without an implant. My question is: Has anyone here been in this situation? What did you do? What WOULD you do if it were you? I am 33 years old. This is my second cancer diagnosis. I was first diagnosed with breast cancer 3 years ago and had a lumpectomy and radiation on the same breast that the cancer came back in.

Answer: I'm sorry to hear you've had such a bad time. I have had a mastectomy but no reconstruction, so can't help with personal experience. I urge you to ask this question on the forums of http://www.bcpals.org.uk http://www.breastcancercare.org.uk http://www.breastcancer.org The first is forums only, the second and especially the third have a wealth of information too All three will give you the opportunity to talk to women who are facing or have been in the same situation, and women who have had tram flap and latissmus dorsi reconstructions. (and all other types of recon). Good luck.

Question: I had a mastectomy 6 months ago and I'm not yet used to the sensation of the implant. When will I feel normal? I am 33 years old and I had a mastectomy (because of breast cancer) 6 months ago using a permanent tissue expander below the main chest muscle. Thus, the muscle needed to be relocated. However, I'm not still used to the feeling of the "new breast" and whenever I develop any kind of pressure with my hand, I feel a breast discomfort and pressure as well. Will I get used to the new data or will I have to live like that (always sensing the "fake" breast?) Only serious answers please! Personal or medical experience would be appreciated! Thank you!

Answer: It takes a relatively long time...I speak from personal experience. I, too, thought it would never feel natural...and it took over one year if not longer. Even today, 10 years later, I feel a tightness in that area, as if my muscles were too short! Oh, well, it beats the alternative.

Question: Reconstuction after a mastectomy? My mom was diagnosed with breast cancer a few months ago. Her doctor suggested that she should get a mestectomy because the cancer is recurring. She has three different procedures that she needs to choose from. Has anyone here had any of the following procedures done? Implants Useing tissue expanders then puts the inplants in. Tissue flap Useing tissue from tummy, back, hip, or buttocks to recontruct Latissimus Dorsi Flap (Upper back tissue) Takes muscle from the back to recontruct DIEP (Deep Inferior Epigastric Artery Perforator) Flap This one is newer the Dr. does a tummy tuck and uses that fat and tissue to reconstruct Which procedure did you get? How old were you when you got the procedure? How were your result? Are you happy with your result? How was the recovering time? And if you have any other information my mom should know about. Thank You (Please serious answers only this is a very upsetting time for my family)

Answer: I just had a patient get the expanders & then implants. She had minimal pain (double mastectomy) & is getting her implants put in this week. The expanders were increased a little bit each week until she was just a bit larger than she was supposed to be so that the skin would not be too tight. ( I am a chiropractor & the patient was sent to me by the plastic surgeon who was doing the procedure ... she had a little bit of rib discomfort from the expanders, but minimal... so that's why I saw her... the actual implant/expansion was not that painful according to her)

Question: What should I expect when going through chemotherapy (TAC)? I am a 22 year old girl that was diagnosed with breast cancer on 2/6/2008, bilateral mastectomy with tissue expanders on 2/21/2008. Sentinal node biopsy was negative, the tumor was 4.5 cm and was ER (-), PR (+) HER2 (-). As a precaution and because of the size of my tumor they have decided to start me on TAC (I can't remember what that is the acronym for). I have opted to have it in what they call dense doses where I will get it every other Thursday for 8 cycles instead of every third Thursday for 6. It will cut the total time by 2 months. So my main question is has anyone every done this dense dose thing with the same type of drugs they will be giving me? What side efects did you experience? I realize that everyones are different, and I figure that with me only being 22 and healthy I will have an easier time with it. I am very positive, I just honestly feel like it is not going to be that bad.

Answer: www.breastcancer.org is a site with a lot of info. I did AC for 4 rounds and then taxol (related to taxotere) for 4 rounds, both dose dense. The AC made my hair fall out but while the thought of it horrified me, actually it wasn't so bad. You will want to get some soft cap to wear because your head will get cold at night. I got a wig, but rarely used it, scarves and hats were much better. Some people have nausea, but there are good drugs to deal with it. Take them exactly as prescribed - you can prevent the nausea more easily that cure it. You will need to drink a lot of water after chemo to flush the drugs out of your system. Also rinse off your privates after you urinate. Your mouth may be sensitive as chemo is hard on mucous membranes, Biotene mouthwash and toothpaste might help. I really didn't have a lot of trouble with the AC. They will likely give you neulasta or neupogen to keep your white blood cells from tanking. The neulasta gave me bone pain, I found the neupogen easier even though it takes more injections. For most people taxotere/taxol is easier, for me it was harder. Lots of bone and muscle pain and neuropathy in my hands and fingers, which is getting better - but slowly. Try to keep moderately active but not to the point of exhaustion. Try to eat well although you may lose your appetite, eat little meals more often. I did a lot of beef broth, yogurt, fruit, veggies. Anything highly seasoned just didn't sit well. Good luck, it's no picnic but you'll likely do fine.

Question: what is a strong long lasting pain relief medication? My husband had a high pressure injection injury, filling his hand and forearm with asphalt aluminum paint. He has had 7 debridment surgeries, a surgery to relieve the pressure that formed in his hand after a week, amputation surgery on his pinky and part of his hand, skin graph to his forearm(not enough skin to cover wound), an intrinsic release surgery to all 3 fingers, and three weeks ago started reconstruction by placing tissue expanders in his forearm. He had extreme pain for the first week along with blisters and vomiting. At 2 weeks had follow up with doctor to add saline solution to the implants. Start to fill and previous incision split open and notice, incisions and had not healed completley, the implants were leaking. So his arm was bandaged and he was sent home. The following week another surgery (#10)to remove implants and replace with new ones. Morphin,demorol,percocets, cause vomiting . hydrocodone is not working and diludid only works for 2 hours.

Answer: Dilaudid is one of the most potent narcotics, about 8 times the potency of Morphine, BUT not very long lasting. Your husband is likely developing a tolerance to the pain meds at this point which is why they are not as effective anymore. My suggestion is to see a doctor who specializes in pain management. Long acting pain medications include MS Contin, a continuous release morphine, oxycontin, a continuous release narcotic (same active ingredient as Percocet). A very good long acting narcotic is Fentanyl. The transdermal form of the drug can last up to 3 days with one patch. Again I highly recommend you see a practitioner specializing in pain management.

Question: I had a mastectomy and reconstruction at the same time.? recently i had my expander taken out and an implant put in its place. I stayed off work for 3 weeks but since i have been back at work i have been in agony i keep having pains in my ribs and in my back and it feels like i have pulled a muscle had various tests done consultant thinks i have torn scar tissue because i have been doing too much i work in a nursery anybody else had similar problems

Answer: Have you seen a women's health physical therapist? A Women's Health PT specializes in issues specific to women, such as pelvic floor dysfunction, lymphedema, pregnancy issues, and cancer issues. Scar tissue mobility, light stretching, and range of motion exercises, along with modalities for pain and strengthening exercises specific to your needs can be prescribed by such a PT. If you are not sure where to find a Women's Health PT, please check the American Physical Therapy Association website at www.APTA.org. Best of luck with your recovery.

Question: Owch Dx ! Bottom side of my face/chin hurts. (back jaw area)? Okay so lately, the side of my chin reallyyy hurts.. Like it's the side.... where the bottom of the side of the face is. Like that bottom side jaw area. And it's just my left side! It's been hurtin! And it's not neccassarilly (neccasarily?) my jaw that hurts, Its more like... the muscles.... or something in there. Somewhere. Idk!! And also, i have braces, and a palate expander (which i'm sure that has nothing to do with anything because i stopped turning that expander ages ago.) And the side of my jaw hurts sooo bad! even if i move my face up and down and from side to side (like if its pulling or pushing that area) it hurts! It feels so sensitive and even the slightest touch would put me in pain. Is this normal for braces wearers? (i've had my braces for a good 4 months) Or is this tmj? My ortho told me that i have strong jaw joints, so i dont think it's that... BUT THEN AGAIN.... my bite has been off causing my ACTUAL jaw strain.. so mabey that's from it. And this is most likely irrelavent, but my upper gums are swolen ... probably from my braces right? How do i make it go down? ANd ughhhh! The side of my jaw hurtssss. I didn't even hit it on anything, it's not the skin that hurts, it's the bone, or tissue. like if i touch the bottom of the side of my face , that's where it is, and it hurtsssss. Ugh! What could this be? How can i make it go awayyy!

Answer: The best thing will be to get the bite adjusted first. Maybe that will take away the muscle strain and jaw problems. If it persists, then you should see a TMJ specialist for an appliance.

Question: Does anyone else have this problem about their braces? Okay so I've had my braces for about 16 months. & I'm supposed to have them for about one more year. My teeth are straight the main thing is their trying to correct my slight overbite. Anyways I've had spacers a few times and a expander but recently I got 2 bands on my wisdom teeth. The first one they put in really didn't hurt but the 2nd almost killed me. The gum tissue was surrounding the tooth but they ended up getting it on somehow. It's been 4 days since my tightening and it's still so sore and swollen where the bands are. I can't eat barely and talking just about kills me. I've tried wax and taking Ibuprofen and it helps slightly but it still hurts so much. Does anyone else have this issue with their braces journey? Any tips and I'd be grateful. :) Thanks. P.S. - No negative/mean answers please.

Answer: I think that you should call your orthodontist office and ask if there are any other alternatives. I know how painful that can be I had braces a long time ago but I really don't know what else if you've already tried wax and ibuprofen. Does ibuprofen normally work for you with other things? Sometimes different types of pain relievers help different people, maybe you should try something different like maybe excedrin, aspirin or something.

Question: Breast Cancer Reconstruction: 6 surgeries and it's not right.What Can I do? I had my right breast removed and an expander placed inside of the remaining skin . I got an implant put in 3 months later (surgery#2) , during my follow-up check-up the doctor put in a drain. Two days later, I was walking pass the mirror of my bathroom and noticed something shiny on my breast were the drainage was inserted , it was the implant coming out and the stitches coming undone. I drove myself to the hospital in fear of infection, it had to be removed( surgery#3). The doctor suggested for me to do the "TRAM " . Three months later(surgery #4) , I had the muscles of my stomach flip up into my breast cavity, so I was cut from hip to hip in this operation plus having my breast cut again. Three months later that failed, the muscle didn't attach right and was flat and hard and by me having my stomach muscle cut I had a hernia . So I had an implant to replace the muscle and hernia repair with the mesh reinforcement (surgery #5). Time passed and after all the swelling went down it was visible that the implant was smaller than the left breast and was lumpy due to dead muscle tissue due to all the other surgeries before. Surgery #6, before the operation , the doctor marked me with a marker for the sections he was going to cut and correct. He marked all the lumps and said he was going to get rid of them as he replaced the smaller implant for a bigger one and also lift the left breast so they could be even. Two days after the surgery, I still saw the same imperfections . My follow-up visit to the doctor I asked him why did he mark the areas and didn't remove them . He told me that it was dead tisues and he only scraped a little ..he could be he didn't want mess with it. He could remove it another time. Keep in mind all these surgeries were done by the same doctor. Most women that have reconstruction on their breast don't have to have these many surgeries. What can I do? I'm so tired of being cut...so tired of stuffing my bra so people won't stare. I can't even wear a T-shirt with making extra efford to look casual. I don't even have a sex-life because of this...I'm too ashame. All I do is cry over this. It have cost over 50,000 dollars , and it's still not right. WHAT CAN I DO??? DO I NEED A LAWYER? HOW CAN I MAKE THIS RIGHT AND GO ON WITH MY LIFE? For me the cancer part was easy...the reconstruction is killing me.

Answer: you need a lawyer!! im a cosmetic tattooist n seen good surgeries n bad ones-this sounds like one of those-this client had holes that had to heal but didnt. she fought n won the case-took a long time but she got it fixed. good luck! sue them sex is not about that-if he cares about u -u shouldnt let that get in the way. i would go contact ''the doctors'' (on tv-email them) n see if they will call u back until u get the help u need.

Question: What to expect after a breast tissue expander exchange?im scared? My friend just got implants and she is very upset. because of breast cancer she got a double mastectomy and had expanders put in. Today she got her expanders taken out and implants put in. she was so excited but now is disappointed and very saddened by the results because number 1-she thinks they are too small and look like pancakes 2- in the right breast there is some kind of dent or something. my question is, is it normal for the breasts to look like that? how long until a change? will they get bigger? will those things go away and look normal or is there any other solution?

Answer: Your friend should talk about her dissatisfaction with the implants with the doctor who inserted them. The doctor can either reassure her that things will change for the better or perhaps some adjustments can be made. Or, if she prefers, she can see another plastic surgeon for an evaluation of the implants and a second opinion. I personally would let the doctor who did the surgery know about my disappointment first. If he/she does not address the problem, then it's time to see another doctor.