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My Breast Reconstruction Journey Phase One: Tissue Expanders

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In this post here, I mentioned I was three weeks post-op, drain free and ready for my first fill. Some of you might be wondering what a “fill” is and what’s a “tissue expander”?

Women like myself who wish to reconstruct their breasts after a mastectomy but who do not have enough body fat to use their own tissue usually use one of two methods.

The first being a newer technique called a “one-step”. The “one step” requires the least amount of surgeries and downtime as implants are placed immediately following the mastectomy.

tissue expander
The second technique is a two-phase approach using tissue expanders later exchanged for implants. This is the reconstruction technique that was right for me.

mentor tissue expander
After my bilateral mastectomy, a tissue expander was placed on each side behind the chest muscle. My surgeon utilized support matrix called alloderm. Alloderm is donated tissue that was stitched to my pectoral muscle to help support the expander and eventual implant.

The tissue expanders are filled with saline over time to slowly expand the muscle and skin to accommodate the implants. I’m pretty tiny so my surgeon only placed 50ccs of saline in each expander at the time of my initial surgery. Most women get more than 50ccs. Since I wasn’t larger chested to begin with and because I had my areola and nipple removed, I had a lot less skin remaining than women who had larger breasts or who had a Nipple Sparing Mastectomy.

When it was time for my long awaited first “fill”, I asked how much we were going to place in the expanders. The surgeon said it’s different for everyone but fill amounts can be anywhere from 30 to 150ccs. It depends how much the patient can tolerate.

I was feeling great, and a bit bold, so I asked for 100ccs. My surgeon’s PA inspected my incisions and examined my skin. She then agreed to the 100ccs in each expander as long as I was feeling okay during the fill.

She swabbed the entire breast area with alcohol that stained my skin blue. This easily removable dye is added to visually aid and confirm that everything was sterilized. She used a little magnetic tool to confirm the location of the port, and marked me with an X on each side where the needle from the syringe would go in. It’s critical not to puncture the expander.

She started on the left side with a syringe full of 50ccs of saline. The needle went in (I looked away) and she placed 50ccs in the tissue expander. I didn’t feel a thing and was doing great. She then paced another 50ccs for a total fill of 100ccs.

Now for the right side. She placed the needle in and OUCH! That hurt! It caught me off guard as I didn’t feel anything on my left side. She said it’s actually a good sign that I have any feeling at all. And that it’s not uncommon for feeling on one side and not the other but that it wasn’t out of the question that I may regain feeling in both breasts.

The fill of 100ccs on the right side didn’t hurt, but I could feel it going in. It was a very strange sensation. Even more so was the sight of such a large change in the size of the breast mound in just a matter of minutes. I couldn’t help but giggle at that. If only puberty had been so easy.

My remaining fills went the exact same way. I never felt anything on the left and I always felt that darn needle going in on the right. I tried to remember that it was good though because it meant that I had feeling in that breast. I can’t complain about that!

My fills were pretty uneventful with the exception of one, my third fill that filled my tissue expanders to their suggested fill volume. I did take some ibuprofen that night as I was a bit sore. Nothing extreme and easily controlled by the little bit of ibuprofen I took. I really feel the botox mentioned here greatly assisted in my expansion process.

For anyone going through this, know that tissues expanders do not look like natural breasts. It’s more shaped like a football and the saline will collect in areas of least resistance. They are certainly odd looking; but in all honesty, the look of them really didn’t bother me. I knew it was temporary. The feel of them was much more difficult to cope with. They are so hard and expand laterally right underneath the armpit. That was annoying to say the least. For me however, they were not necessarily painful, but certainly uncomfortable.

Sizing really depends on your height, weight and rib cage. I’m going to talk more about that in a separate post, but this was my expansion journey. Now that my fills were done, all I had to do was wait to exchange the tissues expanders out for implants.

 

26 thoughts on “My Breast Reconstruction Journey Phase One: Tissue Expanders”

  2. Debby

    It is quite a process. Glad you are doing well. It will be worth it when it is all over and no more need to worry. (((((HUGS)))) Your God Blog Mother.

  4. Ginny Marie

    My mastectomy site is quite numb. I wonder if I would feel the needle? So, the tissue expander is then taken out and an implant put in? I didn’t realize that! This is great information for me to read, in case some day I decide to have reconstruction! (I’ve always kept that door open!)

  5. squawkingalah

    Hello! Thanks for this wonderful site. I’m sitting here with four drains emerging from my body, having had a double mastectomy on January 12. It’s uncomfortable but I’m so relieved that I took this course of action, rather than sit and worry about breast cancer for the rest of my life (I have the BRCA1 gene mutation). Sorry about your mother and Buddy. Good luck with everything.

  6. squawkingalah

    Hi there. I’m reading this with four drains emerging from my body, having had a double mastectomy on January 12. It’s uncomfortable but I’m so relieved I took this course of action so that I won’t have to spend the rest of my life worrying about breast cancer (I have the BRCA1 gene mutation). Sorry to hear about your mother and Buddy. Hope everything goes well for you.

  7. Kim

    Howdy, I am BRCA 1 positive, scheduled for PBM with Recon January 17th. Scared as hell but I know this needs to be done in order to reduce my risk and live a normal life. Your blog has been so helpful.

    Godspeed

    Kim

    1. b

      Thank you Kim. Please feel free to email me or message me on Facebook if there are any questions you may have or anything I can help you out with.

      I will do whatever I can to help.

      And please know I will be thinking of you next week!! Sending lots of positive thoughts and prayers your way! You will do great!

      Much love, b

  8. Gwen

    I have just completed the last of my fills, I felt a lot of discomfort at night and first thing in the morning for the first week after my fills. I had 200cc in the expanders when they were first inserted then had 50cc, 75cc and finally 50cc for a total of 325cc. I am waiting to have the exchange done. Cam anyone tell me how the nipples turn out or give me any suggestions. Thanks

    1. b

      Hi Gwen!

      You will feel so much better after the exchange surgery. I can’t wait for you to be at the tail end of this journey. :)

      I can help answer questions with regards to nipple reconstruction as well. Please feel free to email at the contact section here on my site or through a message on Facebook at https://www.facebook.com/bertalippert .

      I’m happy to share my experience and help you in any way that I can.

      love, b

  9. Moose Boyd

    Hi, this amazing, I have a friend going through the same at the moment. This really helps me understand what it like for her. Thanks.

  10. San Craven

    Thanks for the info I had four jps removing the last one today and will start expanding after chemo n radiation.

  11. Carmela Dawson

    Hi,

    Can I ask how your surgery went? I am BRCA Positive. Having bilateral mastectomy on Aug 21. A little nervous.

    Thx ,

    Carmela

    1. b

      Hi Carmela,

      All of my surgeries went great. I don’t know if you’re having reconstruction or not, or if it will be the same type I had, but I’m happy to answer any questions you may have that are not covered here on my site.

      If you’re on Facebook, you can message me on my Facebook Page here https://www.facebook.com/bertalippert , Or you can send me an email on the contact page of my site.

      If I don’t hear from you before, please know I will be thinking of you on the 21st and sending lots of prayers and positive thoughts your way. If there is anything I can do to help you on this journey, please just let me know.

      *hugs* -Love, b

  12. karen cipriani

    Thank you for your input..I was diagnosed with a rare Phyllodes tumor..only 1% of people get this ..had it in my right breast…after 8 biopsies and a lumpectomy they still can back with neither a positive or negative answer therefore I had a nipple sparring mastectomy on Sept 22…2 stage..dealing with expander and having my first fill in 2 weeks…..you helped me feel better and to know whats ahead for my journey…looking forward to your next stage….

  13. Carmela Dawson

    Thanks! It has been almost 7 weeks since my surgery and everything has been fine. So much better than I had expected and feared.I was fortunate to have a lot of help and support. Reconstruction has been comfortable so far. My p.s. is putting in 50 c.c.s a week so not bad at all. I am grateful for you and other people who have shared their journey-super helpful and calming. I am trying to figure out how I can give back and help others as well.Hope all is well!

    1. b

      Hi Karen,

      I am complete with my exchange surgery and reconstruction and am happy to help with any questions you may have. Unfortunately not all of my information successfully transferred to my new site here but I’m happy to share anything with you that may help! :) Please feel free to send me an email from my contact page on my site here or if you’re on Facebook you can send me a message there at facebook.com/bertalippert

  15. Anonymous

    I recently had expander put in on keft breast it doesnt hurt that much but the pain and swelling under my arms resulting from my surgery hurts alot. I am doing some excercise which helps reduce the pain.

  16. Dawn M Dreher

    I by chance came across this writing. I am so happy to read your words. I understand expanders so much better from your words. I went ahead and read some more of your ideas. Wow! You have made me feel so much better. Thank you so much! God Bless you!

    1. b

      I’m so glad it helped! Please feel free to contact me via my Contact Page here on my site with any questions you may have. I’m happy to help! love, b

  17. Anonymous

    Just had my surgery and my expander put in. I agree the look odd and are uncomfortable. I am waiting on my first fill.

  18. Jen

    Omgosh!! What I just read down to the 3rd “fill” being the worst. Your experience is almost me exactly (except I had nipple sparing surgery). You explained my feelings and emotions perfectly, Thank You, I’m not the only one.

  19. Krista

    Thanks for your story. I’ve just had my expanders put in one week ago and I’ve been pretty bummed about the “look” so far. I know it’s a little thing in the grand scheme of things. Your article has helped me to stay focused on the end result. Thank you

  20. Ang

    Thank you, our stories sound very similar. .Your information gives me hope. I was worried that the look of the expanders were going to be the look of my implants. They feel very far apart. I liked my old breast and the location. I had the double masectomy and that may be why they feel heavy from the healing discomfort. I feel like my arms have to move around them. I was also concerned about how heavy they feel.

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