Advice Needed for Pain from Tissue Expanders

Hi, everyone!

I was diagnosed with breast cancer in April 2020, After several rounds of chemo, I had an bilateral mastectomy with reconstruction (tissue expanders) on September 21. (No radiation is needed.) I’m curious about how long I can expect to be in pain from the surgery and tissue expanders. I’m beginning my 3rd week of recovery, and I still can’t go a full day without needing 1-2 pain pills. While the pain pills are effective, I don’t like how they make me feel, so I’m anxious to get to the point where I’m only taking ibuprofen. The worst pain that I feel is in the middle of my chest. Each breast has a defined hump (for lack of a better word) where it seems that the corner of the TE Is located. It looks like the TEs are about to break through the skin

My questions are as follows:

1. How long will it take after a BMX and reconstruction with TEs until I won’t need to take pain meds?

2. Has anyone else had a wrinkle or corner of a TE that pokes up into hump and therefore causes discomfort? If so, how did you make the pain go away?

3. What can I expect from a fill?

Looking for advice, please!

I am also on week 3 of recovery from bilateral mastectomy with expanders. I can’t speak to number one, since I don’t have a good reaction to prescription pain killers so I chose to just tough it out with Tylenol and Advil. But, I did have the exact same issue you describe in number two, and I can tell you that what solved it for me was getting the first fill! For some reason, the poking corner took on a new shape with the fill and I felt immediate relief. The top edge of the the expanders were also causing discomfort and digging in, and the fill remedied that as well. I really hope you have the same experience. I can sympathize with you So much

My first fill was last Friday, exactly 2 weeks from my surgery date. They put what I think is a lot in...100cc. I am small framed so it was a significant amount on me at least. I was very nervous to get the fill since my empty expanders were so painfully digging in. During the fill, I felt pressure but no pain. I couldn’t even feel the needle go in, my skin is still numb there.And then, afterwards, I felt no additional pain from the fill, just so much better from those corners and edges being “lifted”. I also feel psychologically so much better with the expanders filled. I still feel some totally bearable discomfort and heaviness in my chest especially at the end of the day when I’ve done a bunch of activity, and the pain I’ve been experiencing from the sentinel node biopsy is still there, but the expander pain is so improved that at times I can’t even feel them at all, especially when I’m not moving around. I hope this happens for you too!

hog/goldie, I'm 3 weeks out as well and was just freaking out a little bit last night about my TE pulling at the top edge. Not super painful but weird looking. It seems like my swelling is down so the weirdness shows through! My pain is down but that may be b/c my surgeon put 200cc equivalent of air in my TE's at surgery? I go today to finally get my drains out (!) and my first saline fill so we'll see.

I invite you to join us in the Sept surgery group where we are all at about the same place and share updates. There are just a few of us but many have TEs so I expect we'll be in this together for a while.

https://community.breastcancer.org/forum/91/topics...

Hello,

I had my left mastectomy and expander put in 9/14 with 40 cc of saline and my first fill was 9/30 with 100 cc of saline. I have another fill schedule for 10/9. My expander is 600 cc capacity but they said they can fill it a bit more.

The pain didn't get worse with the fill and if anything got a bit better. The underarm pain where the lymph nodes are is better. They cut under my breast and about halfway around - like by my underarm but not that high; I think because I am wide (and overweight). We talked about the biggest implant they have almost to replace my volume. I do feel still very hard in some places. It seems like my upper chest is more tender feeling now and that I might feel some of the hard edges you are talking about. I hope they get better with the next fill.

I have been feeling better during the day (no pain meds since 9/20) and I was taking a muscle relaxer at night but I stopped that a few days ago. The overall feeling is one of tightness. I found stretching seems to help. When I sit in the same spot for long it gets tighter. My range of motion is almost where it was but not quite.

My PS says that after they fill me to where we want to be, then she waits two months before the exchange surgery. Is that what you are hearing?

I need my right breast lifted but I might not get it reduced since I hope to lose weight (and avoid hormones) and so the right breast will reduce on its own but the left breast with the implant will not.

how do you feel now? Reading these posts makes me really not want to do recon. I’m such a worrier. I wish I wasn’t such a baby. It just seems too much for me to bear. And recon is all I cared about in the beginning. Ug

Update- 10/10

Since my original post, I had an appt with my PS. I showed him the areas where the TE was seemingly about to protrude through the skin. He suggested that a fill would alleviate the issue, so he gave me 150 cc in each breast. I’m thankful to say that this definitely helped! I’m feeling less pain now. Specifically, I no longer feel like I’m wearing a barbed wire bra.

The fill itself was a little uncomfortable. I could feel the needle going though the muscle into the TE, and then I felt pressure as the saline was injected. Other than the small pinch of the needle, getting a fill wasn’t too bad.

I also talked with my PS about the pain I was still experiencing, and he prescribed some pain meds and a muscle relaxer. I get pain relief with 1/2 a pain pill every 4 hours and a muscle relaxer every 8 hours. Beginning on Monday, I’m going to try substituting every other 1/2 a pain pill with ibuprofen.

My breasts still feel somewhat odd. I don’t have children, but I’ve heard other women say that their reconstructed breasts with TEs feel engorged like they did during breast feeding.

In all, I’m definitely feel better than I did when I made the original post. I’m improving slowly but steadily. My PS had to remind me to be patient with my recovery and not compare it to someone else’s recovery timetable. I’m about to begin my 4th week of recovery, so that advice certainly makes sense.

Whew....I am so glad to read some of your posts about TE...I am just one week out from my bmx. I had 200cc’s injected during surgery...I honestly wasn’t expecting that much, but we never really discussed how much I would start with. I trust my PS....he’s known as the best breast man in my area. I know I am still in the early stages of recovery, but the tightness is something else...should be getting my drain tubes out Thursday, and I cannot wait! It helps so much to read what others are experiencing.

I am almost 10 weeks out and just had my final fill and scheduled the exchange surgery for 11/16. My PS said initial stabbing pains were either from where the expanders were stitched in place (and that those internal stitches dissolve in 2-3 weeks) or from poking by the expanders. I could see a fold on one side that skewed my nipple outward but as the expander unfurled things straightened out.

Each week after 3 out I felt better and better. That's also when I started fill ups--I came out of surgery with 150cc and got 60cc a week for 6 weeks. Once early on I pushed a fill back a week because I did not feel ready to take on more but other than that I liked that pace. During the fill (which is with a small needle through the port and took maybe 45 seconds) I couldn't feel a thing on one side, but on the other I sometimes felt a small jolt when the port was located with a magnet or a prick from the needle stick. I would wake up with pain the next morning and feel stretched for a day or two but the internal poking got better. After this last fill I realized that ibuprofen has wrecked my stomach...hoping in a month I can take it again or some other NSAID because tylenol never helps my pain.

Now I'm overfilled at 510cc (implant will be 485cc) but more comfortable than I thought I would be at this point. Back sleeping is still rough (pillows under knees and elbows help) and some nights I end up back in recliner.

Hang in there, it gets better. I don't regret a thing!

I too am experiencing pain from my TE's. It's only when I try to wear a bra of any kind. It's at the bottom where the elastic is. I asked my surgeon why because it feels like there's a seam sticking out there causing a lot of fraction against surrounding tissue. She said it could be. Ugh. I am confused by all the numbers I hear on these threads. I am overweight at 230 lbs. and 5'7. I had 570 gms of tissue removed in the middle of June. They put 350 in at time of UMX. I've had 50 cc's every week since the subpectoral TE reconstruction began. Then switched to 100cc's every 2 weeks. My pain reduced substantially between weeks 6-7. I used tramadol after the first fill which felt really painful for 1.5 days. Then, only tylenol since, but I take other pain meds for my serious fibromyalgia- an nsaid and gabapentin.

I feel the hardness and the pressure after expansion. Because of my fat, it's difficult for them to find the port, but they're mostly able to do it pretty quickly.

My PS is requiring at least a 3 month waiting period after final fill to allow for a sac to be firmly in place for the final implant, so I'm expecting about Feb. I've always been flat so I decided to go up a size. Size 44B just didn't look good and was very hard to find bra sizes.

My expander has a max fill amount of 800. It's currently 600 and we have 100 more scheduled. Then, I'll get a lift and small implant on top of pectoral on the healthy side. Does anyone else have to wait that long for a pocket to form? Is anyone getting a fill that large? And my biggest question is will salin or silicone be as firm as subpectoral expanders? It is SO hard.

I had my left mastectomy 9/14 and had three fills of 100 ccs each. I had about 50 ccs out in during the surgery. My expander is 600 and she might fill me a bit more. I was 44C but it is different for everyone. She said she will wait 2 months after my last fill. I have heard 1-3 months is common. Sometimes I use a muscle relaxer the first night or two after a fill. I use ibuprofen too. I kind of got used to it feeling tight after a fill for awhile. I’m starting chemo next week and will finish January 6 so I’m planning to get three more fills and hopefully in February or so have my exchange surgery