TE leaking- punctured

OnTarget

I had an infection and lost an implant during the early period of the COVID pandemic. After waiting 6 months, I had a new TE placed to start expanding again. I was almost done filling, when I felt that my TE was not nearly as large as it should be. I told the PA, who told me "ma'am, tissue expanders don't leak". I pointed out that some do in fact fail according to the literature (I didn't mention punctures). She told me I was wrong, and she just wouldn't listen. My left breast has a 605cc implant in it, and my TE was expanded up to 640 at that point, and it looked half the size of the 605 implant.

No offense, but it doesn't take a medical degree to know that two items with the same volume and same basic circumference should be about the same size unless one was digging inwards, which it was not doing. Also, TE's normally have MORE projection than implants, so I would have expected the TE to possibly stick out more than the implant.

She also told me not to worry, because the skin wouldn't shrink.

Don't worry? We haven't even expanded up to the amount we need! I'm not worried it will shrink, I'm worried that we have half the size we need to start!

She suggested that I mention it to my surgeon in my pre-op. Pre-op?? Isn't that a little too late at that point? How about now?

I annoyed this PA enough that she sent in a second PA to help me.

The second one patiently explained to me that "TE's don't leak, and we didn't puncture it". She explained that it may have rotated.

I'm sorry, but I can't see how "rotating" will eliminate volume.

She completed my final fill up to 740cc's and told me to monitor it myself and let them know if it leaked.

I already let you know it leaked!!!

She didn't offer to measure it with their tools to get a baseline so we could empirically test it if I still felt it was leaking.

I went home and waited a few weeks, and then made an appointment with the surgeon. He saw it and said that it was leaking and had to be replaced.

After surgery, he confirmed that the TE had been punctured and that it wasn't a failure in the valve.

Just for info if anyone searches later and wants to know how I identified the slow leak, here were my observations:

* Lost volume in the upper pole first- it has previously been weirdly large- I'd had uneven filling because my capsule wasn't stretching

* TE felt softer- a filled TE should be a bit firm

* TE eventually got very loose and I could make it jiggle like a water bed

* My TE never fully deflated because the leak was at the top- as soon as the pressure released, it would stop leaking

* My fills which should have been very tight towards the end, were super easy

Despite the PA not measuring it, we did figure out a method to measure. We selected two landmarks on my chest that were diagonally distant. We took a pic to remember the spots. We used a measuring tape to measure the distance between the spots. After a few weeks, the distance was reduced, so proof was established. At that point, it was pretty lax, so the surgeon didn't need any proof, he could tell by looking at them and feeling them.

I had a new TE put in, and they were only able to fit 300cc's in it during the operation. That's how much it was deflated!