When Do ExPanders Go In

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Pure
Pure Member Posts: 1,796
edited June 2014 in Stage III Breast Cancer
When Do ExPanders Go In
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  • Pure
    Pure Member Posts: 1,796
    edited February 2010

    before rads or after-at ASCO they kept talking about the importance of doing it prior to RADS for the best look but everyone else says their docs wont do it until 4-6 months after rads.

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  • janincanada
    janincanada Member Posts: 258
    edited February 2010

    There are a lot of options.  They can be placed at any time.  Check out the threads for TE's and reconstruction. My doc recommended 12 months after rads for the best result. I'm glad that I waited because my head was in the right place and it was far enough away from herceptin/etc. Expanders can be placed at time of initial surgery or any time after even 10 years or more.  It is when you are ready, your choice not their's.

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  • everyminute
    everyminute Member Posts: 1,805
    edited February 2010

    I was at sloan kettering - I had immediate expanders (because they initially thought maybe I wasnt going to need radiation) but ps used alloderm anyway just in case.....anywho - I had fills during chemo and then switch to implants in between chemo and rads.

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  • karen1956
    karen1956 Member Posts: 6,503
    edited February 2010

    Jen....my expanders were put in at the time of my bilat....I did immediate recon....fills during chemo....finished chemo, then started rads.....exhange 7 months post chemo....

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  • geewhiz
    geewhiz Member Posts: 1,439
    edited February 2010

    Sloan Kettering is one of the only hospitals doing the protocol that everyminute mentions...where implants are exchanged PRIOR to rads. I have researched the heck out of it, believe me!! It seems to be a 50/50 crap shoot either way. I have opted for this protocol and have had fills during chemo and will exchange prior to rads. We will see how it goes, I will keep everyone posted!  

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  • Jayne_in_UK
    Jayne_in_UK Member Posts: 517
    edited February 2010

    Jen I had an expander put in at time of mx and filled a little at same time. Had more fill, then chemo, then rads. I will wait probably about a year after rads to do exchange. I have had no problems with my expander so far. There do seem to be quite a few different approaches to this. Good luck whichever way you go.

    Good luck to you too Geewhiz. 

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  • BrandonMom
    BrandonMom Member Posts: 412
    edited February 2010

    Pure, I'm thinking you are confusing placing expanders with exchange/reconstruction.  I think most of us get expanders placed at the time of mastectomy, so they can perform a skin sparing mastectomy and do the expansions prior to rads (easier to expand unradiated skin).

    About 6 months after rads, most plastic surgeons will then do the recon or in some cases exchanges.

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  • Pure
    Pure Member Posts: 1,796
    edited February 2010

    What is the difference between an exchange and an expander?

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  • karen1956
    karen1956 Member Posts: 6,503
    edited February 2010

    Jen...expander is what they put in at the time of Mx....it is placed to keep the "pocket" and help stretch it so you can do the implant....the expander has a "port" which the PS uses to fill with saline (hence "fills")....my onc did them every 3 weeks the same day as chemo....I only had 3 fills as I was as big as I wanted to be and stretched to the max!!!  Exchange refers to the surgery when the expander is taken out and the implants are put in.  Typically your expanders are "filled" to slightly larger than the size implant you will get.  hope this makes sense.  Karen

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  • janincanada
    janincanada Member Posts: 258
    edited February 2010

    The expander is a a form that has a valve kindof like a port.  It is placed under your pec muscles and some saline is inserted at time of placement.  Then over the next few weeks or months, you go back and they use a mini studfinder to locate the port and inject more saline into the expander.  Sortof like chemo. The gradual increase in volume allows your skin to adjust just as your belly does when you are pregnant.  PS's vary significantly in their protocal for how much to fill each visit and the length of time between visits. So the length of time that it takes to be expanded varies greatly, your comfort level, how much volume you need etc. Once the expanders are at the required volume which is usually bigger than your desired end result, you wait.  Again PS's vary significantly in the amount of time that they want you to wait before exchange.  This allows your body to adjust and the skin, tissue and muscles to adjust.  At exchange they open up the same scars, take out the expanders and replace them with final implants which could be saline or silicone.  Then after a few months you have to decide whether to do nipples, what kind, tissue, 3D tattoos etc. 

    I recommend that you check out the reconstruction threads on this stie.  They are highly knowledgeable people and have lots of links to help you.

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  • YATCOMW
    YATCOMW Member Posts: 664
    edited February 2010

    I had my expander put in at initial surgery and had it filled during chemo HOWEVER....when I went to MD Anderson to have my rads done he didn't want them filled to do the rads so...... I had to have them emptied....do the rads .......and start over......big PAIN.

    Jacqueline 

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