tissue expander

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53puppypink
53puppypink Member Posts: 3
edited June 2014 in DCIS (Ductal Carcinoma In Situ)

I had a double mastectomy last July, with reconstruction at that time. But one implant got badly infected and had to be removed. Here I am a year later with an apointment in 2 weeks at Toronto General hospital, to which I was reffered, to hopfully start reconstruction on that side. Just wondering what to expect, so I have the right questions ready. Tissue expander would be the first step, wondering how long the expansion process takes- I'm a C cup... wondering if they'd do that, I'm off work, and I'm hoping a month or so later have it removed and the permanent implant put in? Anybody have a similar situation?

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  • Beesie
    Beesie Member Posts: 12,240
    edited August 2013

    Since your question is about reconstruction, you might want to repost it in the Reconstruction Forum on this board.  I'm sure you'll get more answers there.

    I had reconstruction at TGH, but that was 7+ years ago; the plastic surgeon I had is now at a different hospital.  My experience was that the PS wanted to go slow with the fills.  I'm just a "B" cup but my fills took about 3 months.  The PS always stopped the fills as soon as I felt any tightness so I never went higher than 60cc per fill and near the end, the fills were smaller than that.  Thanks to going slow, I never had any pain, just a bit of tightness the first night after the fill.

    After all the fills were done, my PS wanted to wait at least another 3 months before replacing the expander with an implant.  This is to give the muscle time to settle into the new stretched position so that it's less inclined to spring back and squeeze the implant too much.  Not all PSs do this, but I believe that many do. 

    Even if the PS you are seeing at TGH doesn't insist on that holding period, I can't imagine any way that you will have the expander for only a month.  First, given your previous issue with infection, I would think that the PS will want to expand slowly.  And second, there's just the practical issue of scheduling two surgeries, the first to place the expander, and the second to remove the expander and place the implant.  After my expansion was done and I'd waited the 3 months, I had an extra month delay just for scheduling.  The PSs at TGH work with the doctors at Princess Margaret Hospital, so many of their patients are having mastectomies for breast cancer at the same time as the first reconstruction operation (that was my situation).  Because these women are being operated on for cancer, naturally they are prioritized on the surgery schedule.  Once the cancer has been removed and the PS is just dealing with reconstruction, there is less urgency.  So it can take longer to get onto the operating room schedule.

    Probably not the answer you were hoping for, but I hope that helps explain what to expect.

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