Tissue Expander Removal without reconstruction

Sabbymama

Hello Ladies! I had a single mastectomy with a tissue expander placed last year during the height of COVID. My surgery was moved up (because of positive lymph nodes) to fit it in before all "unnecessary" surgeries were stopped and I actually had only one appointment with my PS and one with my BS before the procedure. I had little time to process my options and frankly, due to COVID, very few options at all. No opportunity for a double mastectomy as it was considered "elective" and the whole thing just felt very rushed. Anyway, long story short, I ended up with a tissue expander thinking that I would eventually pursue DIEP but I now realize that it is not for me. With my husband's job, we move countries every two to three years, and having a consistent medical team is challenging and I do not want to begin a lengthy surgical process at this time. The expander is uncomfortable and the BS believes that the radiation therapy may have resulted in capsular contraction.

Therefore, I'm considering having the expander removed and possibly along with it, a prophylactic mastectomy on the right side this summer. My BS here says that she can perform an aesthetic closure and I will meet with her next month to see photos of her work and discuss the procedure, but I'm hoping to learn from your experiences. For logistical reasons, July is the optimal time to have the surgery done and I don't see any other option if I want to have my husband at home to help me during recovery . If I wait, I might be stuck with this expander for a long time. If I decide to move forward, I will likely miss the chance to drop my daughter off at her university in the US this August and I am really torn emotionally about whether or not it will be worth it.

Has anyone opted to have their expander/s removed and forego implants or autologous reconstruction? Were there any complications? How long was the recovery period for you? Did it require any additional procedures? Any words of wisdom would be greatly appreciated! Best wishes to you all.

Sabrina

naps

Hi,

I had my TE removed nearly 3 years after my umx --I had decided not to proceed with recon and then it took me awhile to find the time and wherewithal to schedule the explant/aesthetic flat closure surgery. I had it done under regional anesthesia with sedation, not a general. I had a couple days of post-op discomfort and a drain for a few days, I think. No complications really, although I did have some mild lymphedema around the site that resolved over a few weeks. It healed well--I was a bit worried bc of the radiation tx. I had to be careful with lifting, etc., for several weeks, I think, but I flew to my parents' 50th anniversary party about 3 weeks after the procedure and that was fine. I don't anticipate needing additional procedures, though the PS said maybe fat grafting (way) down the line bc there is pretty thin tissue in some areas. It was a real relief to get it out and definitely the right decision for me. Much more comfortable. I did need to go through some adjustment to the new look, but that didn't take too long. I figured I had already adjusted to lots of strange and unexpected things, so this probably would be doable.

Good luck! Feel free to PM me with any questions.

saltmarsh

Hey! No answers from me, sadly, but I am also considering this option. While I originally thought it would really bother me to have only one breast, I'm no longer sure that's true, and I'm not at all sure the pros of reconstruction outweigh the potential cons. I'm supposed to meet with my PS again this Friday, and I anticipate her wanting to schedule my implant surgery, and the closer I get the more I think, "I'm not at all sure I want an implant enough to risk breast implant illness. What if I just went with an aesthetic flat closure?"

Sabbymama

Hi Saltmarsh,

I actually had my tissue expander removed along with my right breast two weeks ago. I had to move up the surgery because my breast surgeon is going on maternity leave in August, so I bit the bullet and had it done. It went much better than I had expected with very little pain afterward and I was pleasantly surprised! Of course, the results are far from perfect and I suspect I will still have to have some work done to get an actual "aesthetic closure". The sutures look good, but there are dog ears and the right side seems to have a bit more tissue than the left remaining. The surgeon believes this will even out when the swelling goes down and I am hopeful, but not so sure.

Basically, I want to say that along this journey, I have come to learn that appearance isn't everything and I have to accept my "new" body however awful it may be....lol. I remember my first breast surgeon (after my left mastectomy) telling me that having no breast on the left and a very large one ( I was a 40gg) on the right would be too overwhelming for me and I should go with the implants or some reconstruction so I'd feel more "normal". I still felt very unbalanced and deformed, so I did regret getting the expander, but I learned to live with the inequity. Things are never going to look perfect but I'm grateful to be alive and I've come to terms with my new life. Today I received a pair of "knitted knockers" in the mail and once my incisions are healed, I'll have fun trying them out . Good luck with whatever route you choose and I hope you had a good chat with the PS!

Cheers,

Sabbymama