Tissue Expander Unevenness

Hello, I'm new to the forum, but I would like to go ahead and thank everyone who participates on these boards. I'll briefly go over my circumstances and move on to my question. I tested positive for the BRCA2 gene mutation and underwent a bilateral prophylactic mastectomy in February and I'm almost done filling the tissue expanders. I have a mother who had breast cancer and has been in remission for ten years (yay!), and I have seen what incredible things she has accomplished and what truly awful ordeals she had to struggle with. I had the chance to take a preventative step and I don't regret it for a moment. That being said, I am concerned with how my expanders currently look.

I understand that no reconstruction is perfect, and honestly the left side (all things considered) is perfect in my eyes, but the right side is sitting a little strangely. My left expander is expanding at the bottom and sitting at a natural level, but the right side is sitting noticeably higher and is not expanding at the bottom. In fact, it is trying to expand upwards and has considerably less projection than the left side. Before the surgery my breasts were not even and the right side (my current troublemaker) was clearly larger than the left. The bottom skin of my right breast is looser and wrinkled where it's not being stretched, but the tissue expander simply won't stretch out in the middle or at the bottom. It's not completely flat, but it is very obvious as it sits higher and isn't as full on the bottom.

My plastic surgeon insists that all this process is for is to stretch my skin, but it should also be stretching the muscle out too, right? He tells me not to worry because I have the skin there that I need (the loose skin at the bottom) and that all of it can be manipulated during the actual exchange. I felt confident in him at first, but now I'm not so sure. I don't see how the implant will appear more projected, like the left side, if the muscle isn't expanding. His nurse actually talked to me after I'd asked (for the 5th time) and told me that it may look this way now, but the results will be different after the exchange. I know that he can manipulate the pocket and it can sit lower, but the actual projection just seems like it won't happen and I'll be dealing with the loose skin and unevenness. I feel terrible because I want to believe my plastic surgeon and his nurse, but my gut is disagreeing.

Thank you to anyone who reads and replies. Whether it's good or bad, I just want to hear someone else's opinion or experience.

Bumping for Arii. Does anybody have some insight on this?

Thanks!

Arii, My expanders were completely different during the filling. One was sitting much higher than the other & they were filled at different rates & to different totals. They look great now. Your PS & nurse are right, these are just expanding the skin, they will shape the pockets during your exchange. Believe it or not, they sit you up during surgery to check to see how they will look afterwards. And if you need to have a revision to slightly change it, it's a pretty quick & easy surgery. I hope others will chime in to give their experiences. I know, it's hard to believe that those horrid things will look good once they've done their job, but they will. good luck, GG

Hi Arii,

I agree, my TEs are not even. My right is lower than the left. Although I knew before surgery that they wouldn't be perfect I was still disappointed to see one lower than the other as I was supposed to keep them for 6 months. Six months of unevenness over summer was a bummer (this aside from the fact that I you can clearly see the outline of the TEs - including the tabs on the sides).

It was comical in the office when we (DH and me) pointed out they were uneven. They were surprised and it was like watching a dog cock his head when he hears a funny sound; three people - the PS, and two PAs all tilting their head while looking at my slightly lopsided TEs.

It is interesting to me that my surgery notes even point out that they sat me up during surgery to verify the TEs were place evenly! Ha - I must have been lilting to the side a little. My guess is, and the PS said this, that everyone is a little uneven in some way. I think if I would have stared at myself long enough before surgery I might have noticed this myself.

My TEs are above the muscle so I don't have the concern about muscle stretching, but my TEs are filling a little differently, too. One looks fuller and more projected while the other is flatter and for some reason looks less full although they each have the same amount. I have heard the same thing over and over - this isn't what I will look like later. I have more filling almost under my arm and flatness near my sternum. I believe this is to get that side skin to stretch.

Just have to be creative in dressing for now! Although I did try on a bikini top and all my DD said was that it was cute!

Hope all goes well and you get the reassurance you need.

I know this is a bit older of a thread but I'm wondering about YoungBRCA- who asked about capsular contracture with TE. How are things working out. I have had it with my TEs and when I went in for my exchange, I came back out with TEs again and I'm starting all over! My mind is swimming and I'm looking for a "buddy" who has or is going through the same thing!

So glad I found this thread! My TEs have been uneven all along and today was my last fill. I've been repeatedly told it will all work out with the exchange. The fills have been painless up till now...my left side (the bigger one) is really aching! Ugh.

Yes Ringelle do share why you are starting over! Omg you poor thing. Of course your head is spinning.