Breast Expanders...What are They and How Do They Work?

Breast Tissue Expander

What in world are breast tissue expanders and how exactly does that work? I answer these questions often. As many of you know, I am going through this process right now. Like so many others, I wasn't even aware that this was a possible step in breast reconstruction. I had my bilateral mastectomy on February 14, 2013. After my breast tissue was removed, my plastic surgeon put in tissue expanders. Expanders are implant like devices that are used to expand the breast tissue and muscle to eventually comfortably fit breast implants, creating a more refined breast shape and better symmetry.


When the tissue expanders are first positioned on the chest wall, they are partially filled with saline. A few weeks after surgery, the expansion or "fill'er ups" (as I called them) are started.  As you can see in the picture above, the expanders have a fill port that is built into the front. They are filled every week or two until you get to the desired size you would like.
I had five fill'er up appointments with one of my favorite nurses, Sharon. First she uses this tool in the top left picture that has a magnet
to find the exact location of the port and marks my skin with an "x." She then accesses this port with a needle through the skin and adds saline from those huge syringes in the bottom picture to the left. A typical fill is about 50 cc's of saline (an equivalent of 10 teaspoons), but is limited by the tightness of the skin. 

 

I would not describe the fill'er ups as painful, but there is a sensation of stretching and pressure during this procedure.  Most women find this is not too uncomfortable. Usually the following two days involve some discomfort with pressure or muscle soreness, nothing a little Advil won't help. 

The expanders do feel weird. They make you feel a little freakish and are slightly uncomfortable at times, so keeping a sense of humor is essential. They are heavy, hard, and have a bumpy strange shape to them.  I often joke that I feel like I actually have two stones in there! You learn to joke about having titanium boobs, cute cups, Barbie boobs, perky ta-tas…really the jokes can be endless. But the reality is that having breast expanders is difficult. Not only is it hard on your body, but it’s also hard on your mind, spirit, and sexuality. You've lost nerve endings in a large portion of your body.  I deliberated on whether to add this, but really, it is too funny not to add.  You have heard of phantom limbs, which are sensations felt even though a limb has been removed.  Well for the first couple of months, let's just say I could tell when it was cold!  Talk about strange!!

Breast Implant

I have just finished receiving my fill'er ups.  We will give the tissue and muscles two months to relax, and then I will have surgery in July. This is an outpatient procedure that involves exchanging the expanders for implants which will look similar to the picture on the right. 

Once upon a time, I said that if I ever had the money and a chance to have any plastic surgery, my wish would be to get a breast lift. Well I am getting a little more than a lift, and not in a way any of us would choose.  Although it is a silver lining...I guess we should be careful what we wish for.  ;)

 

Thank you Sharon for being such a great nurse, and your encouragement to write this blog.

Our new friendship means the world to me.