Reconstruction is a scary time for anyone who has to go through it.
And there are so many questions that run through your mind about the process and even more unknowns that you worry about.
It can defiantly feel overwhelming, but just know you got this!
Having recently gotten tissue expanders in, I figured that now would be a good time to share what my experience was with this processes and share everything that I’ve learned about them
If you’re looking for something specific, feel free to use the table of content down below to skip around, or just continue reading on 🙂
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Table of Contents
What Are Tissue Expanders & Why Have Them?
Tissue expanders are an inflatable implant that stretches the skin to prep it for permeant reconstruction. While not everyone will need to use a tissue expander, it’s a great option for those who don’t know what type of reconstruction they want to undergo yet or for those who need further treatment.
While my scans show that there is zero evidence of cancer left in my body, I still have to go through curative chemo and radiation as a preventive/curative step. So we choose to go for the temporary tissue expander, to protect my tissue based reconstruction form any unnecessary damage from radiation treatments.
Breast tissue expanders are first filled with air, and then filled with saline a week from your initial surgery.
What The Surgery Is Like
The idea of surgery feel scary for me, but honestly this was the easiest part!
About 3 weeks prior to surgery, your surgeon will tell you which medications and supplements to stop taking (this is because some supplements encourage bleeding) and which medications to pick up.
The tissue expander surgery is an out patience procedure that last about 3-4 hours. While this is an out patience procedure, you will still need someone to drive you back home or to your hotel. You will likely be on some heavy pain medications for at least a couple of hours. But truthfully I was able to cut back to just acetaminophen and naproxen in just a day.
For the surgery itself, they’ll run through all your vitals and what you’re allergic to before taking you to the OR. They should also ask you if you had any lymph nodes removed and on which side. This is because they’ll need to avoid putting IV’s or taking your blood pressure on the side you had the lymph nodes removed.
Once they get you to the OR, they’ll start with the anesthesia, which will burn a little at first. But, soon you’ll be knocked out. The whole thing only feels like a few seconds for you, and then you wake up in recovery with your new temporary boobs!
Aftercare will be slightly different depending on your situation but there are a few basics that are similar across the board.
You’ll likely have a whole bunch of antibiotics and anti-seizure medications that you’ll be taking for at least a week. These are really important to stay up on because you have a foreign object inside of you and you want to avoid an infection. You’ll likely be given a whole bunch of narcotics as well. I found that I didn’t really need them for pain management after the procedure, but don’t get rid of them so quickly! You might want them for the fills (more on that later)
You’ll likely also have a few drains. I had 4 (2 on each side) and honestly this was the worse part of the whole thing for me. It’s possible for a drain to sit on a never and when that happened, it hurts like hell. I ended up having to be pretty medicated every time we needed to empty the drains.
The good news is, if you follow your doctors orders, you can normally get them out fairly quickly. I had my first 2 removed by day 4, and that relieved all the pain that I was having with them. And then got the last two removed by my 1 week follow up.
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Follow Up & Fills
One week after surgery you’ll have your first of a few post ops!
During this appointment they’ll check the health of your breast skin, nipples if you still have them and see how you’re healing up. They’ll also remove any wrapping if they placed it (I was all wrapped up in DermaFilm) and your drains in you are producing less than 30mm of fluid a day.
After the check up, it will be time for your first fill! The air that they put in the expanders initially doesn’t last long. My expanders started to lose air after only a few days. This is because the expanders aren’t air tight, but they can hold saline.
The process of getting the fills themselves isn’t too bad. For the first fill, they’ll find your port (it will be the harder object towards the top of your breast) and suck out any remaining air from the expander. You’ll feel some pressure from this but it shouldn’t hurt since your chest will probably still be super numb from the surgery.
Once the air is out, they’ll start injecting the saline 50cc’s at a time. When talking to my surgeon and nurse, I was told to get as much as I could during this fill while still feeling comfortable. This is because I have AlloDerm, so I needed the pressure of the expander up against that to start having it integrate with my body. But getting too much at one time can be very uncomfortable (or even painful).
I ended up getting 450cc’s in each breast during my first session. It was originally 500cc’s, but once I set up from the table, I immediately felt the weight of the expanders pull against me and that caused so much pain for me. So we took out 50cc’s and it felt a lot better.
Wearing a supportive bra defiantly helped to alleviate some of the pain for me. But it honestly may take a few days for your body to adjust. For the first day after my first fill, I needed to get back on my narcotic. But after that, I was able to easily manage my pain with naproxen and acetaminophen.
With my second fill, I got 100cc’s in each breast and that went so much better for me. I was still in a bit of pain from the first fill, but for me, getting up to 550cc’s in each breast instantly alleviated a lot of the strain that I was feeling on my sternum. Along with a good supportive bra, I didn’t need any medication after the second fill.
Getting a Supportive Bra
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You’ll likely have a nice adaptive bra from your mascestomy already. But it will also be kinda gross if you’re like me because I wasn’t able to change out of it for ten days!
So finding a really good supportive bra is a MUST! It will give you some relief from the weight that’s sitting on your chest and also make things feel just a bit more normal again.
When you’re bra shopping, keep in mind that your band size will likely be larger after surgery. I went from a 34 to a 38. This is because unlike natural breast, the tissue expanders are more structured and less malleable.
My surgeon suggested finding a bra that would zip in the front with no underwire (this is important as the wire can affect your healing!) and that was a huge challenge for me with larger breast.
I ordered these one on Amazon and I think they would be great for anyone between and A-C cup with a band size under 36. But these were too tight for me.
So I needed getting these from Lululemon and they were prefect! They are defiantly on the expensive side. But you can buy them on sale online for a major discount. And if you sign up for their free membership, you can exchange them if the size doesn’t fit.
When picking out your bra, remember to make sure that it’s not squeezing your breast together but holding them firmly in place. You want your tissue expander to sit perfectly in place with little to no strain.
What Do They Feel Like?
The process of getting the tissue expanders and the initial feeling is very uncomfortable.
There were times where I would wake up in the night thinking ‘I need to get this bra off’ only to remember I wasn’t wearing one. It feels like you have an iron corset on that you can’t escape. There is also the issue of tabs that hold the expander in place. Like I mentioned above, they can cause a lot of strain on your chest. This strain limited my range of motion so bad at first that I couldn’t even turn my head that far or reach to scratch my arms.
The good news here is, this discomfort and pain does not last!
Of course how long the discomfort last depends on your own personally healing journey. For me, most of the discomfort was gone by the start of week 3, so I’m super thankful for that. I’ve seen online some women say that feeling only lasted 2 weeks and others say it lasted 6 weeks, so the time will vary. But it won’t last forever.
Once the iron bra feeling goes, you’ll still feel some stiffness from your expanders. This is because they use a more durable silicon and are sewn down so they don’t have much movement. I’m 4 weeks out from my surgery when writing this and the expanders feel a bit more soft and have settled a bit. But they feel no where near real breast.
That said, they don’t feel bad. Four weeks out, and it’s easy for me to forget that I have expanders in when Im just lounging around. You get super use to the feeling. I think it also helps that I had a skin and nipple sparing macestomy as well. Now that the numbness is fading, I have really decent feeling on my breast and nipples, so it’s really easy to trick myself into forgotten that anything happened.
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Adjusting To A New Look
I think one of the hardest things for many women who go through such a transformation is adjusting to a new normal. This is going to sound silly, but I struggled for the 3 weeks that I was in hospital and recovery wear. Yes, they were pretty (and I do highly suggest them ) but I felt like my style and expression was restrictive.
Once I was able to wear my regular clothing again, things felt different. My chest looked a lot larger and lifted, so it felt almost cartoonish. I also have new lumps, and dips that weren’t on my breast before and that can show through clothing. While I don’t feel self-concious about my new body, I do feel uncomfortable in a lot of my clothing. So much as changed with me in just a month, that I had to learn to adjust.
Part of that adjustment for me was clearing out some clothing from my wardrobe and making space for new items. But I also spent a lot of time in the mirror trying on different outfits, and finding new ways to style them with the body that I have now. Styling them and looking at myself in then mirror really helped me adjust to this new look.
Quick Things To Know About Tissue Expanders
After my last follow up appointment for the expanders, my surgeon gave me a lot of useful information as far as things you’ll have to consider with expanders.
This first being no wearing dark colors in the sun! This is because darker colors can trap heat in and cause serious injuries to the now every thin skin on top of the expanders. I typically look best in light colors anyways, but this wasn’t something I had thought of.
I was also warned to be careful of the clothing/jewelry I decide to wear. Anything abrasive can start to cause damage to the skin and you may not notice because of the lack of, or diminished sensation in the area.
He also told me to be cautious of sand getting in-between my bathing suits for the same reasons as above. These are things that I just hadn’t really thought about but important to know about, so I wanted to share.
The Next Steps
What happened next after you get tissue expanders is up to you and your treatment plan.
Many of you will have expanders in as a stop gap measure as you figure out what you want to have done. You’ll be able to have many different conversations with you team to determine what’s going to be the best fit for you.
For me, after chemo and radiation, I will have my DIEP flap reconstruction surgery where they’ll take the tissue from my belly and use it to reconstruct my breast. While I’m nervously excited for that day, it’s still a ways off for me.
In the mean time, I’m here for the ride, enjoying life and thankful that I was able to deal with my cancer early, giving me the best chance for a cure.
I will keep updating my experience with cancer and reconstruction on this blog, so if you ever have any questions, then feel free to leave them down below. Or if you want to keep up in real time, be sure to check out my IG.