American Society of Plastic Surgeons
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Breast Augmentation

Post bilateral mastectomy recon

CorgiMorgan Rogers, AR
5 months ago

Hello~ I had bilateral mastectomy for bc 11/19. Expanders were placed at that time. Everything happened very quickly, and in short, Upon research and reflection, I do not want reconstruction. Can anyone of you tell me what expander removal without implant placement would involve? Thank you so much for your time.

Steven Wallach, MD New York, NY
5 months ago

If you just want the tissue expanders removed, it is usually a very simple procedure. It can be done at any time.

Rachel Scott, MD, FACS Danville, IN
5 months ago

Thank you for reaching out - your situation is not unusual and there are also ladies who go on to complete their implant placement and then decide that it was not the right choice for them. If you decide to have the expanders removed and not have any other type of reconstruction surgery, then usually it is a fairly short, straightforward surgery to open the old incision, remove the expander and sometimes scar tissue depending on how long they have been in place, and remove the extra skin left from your original mastectomy. Drains are typically left in place to prevent fluid buildup, and most patients have very little if any discomfort. Once healed, this leaves the chest contour and scar area flat so that a breast prosthesis can be worn if desired. As with other post-breast cancer reconstruction surgeries, this falls under the umbrella of insurance. I hope that this is a helpful, and wish you all the best in your journey!

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Debra Johnson, MD Sacramento, CA
5 months ago

I hope you are recuperating well after this big surgery. Every woman has to make rapid decisions once a cancer diagnosis is received. Sometimes we are in such a rush we don’t have time to fully consider our options. You may feel that placing tissue expanders was the wrong decision. Removing them is fairly straightforward, although you may require some additional skin removal since often extra skin is left when the TEs are placed, knowing they will take up the skin excess quickly. However, now that you are not in such a rush, be sure and take your time to thoughtfully consider your options. Discuss your concerns with your plastic surgeon and together decide the best way forward. Good luck and good health.

Daniel Allan, MD Las Cruces, NM
5 months ago

They can be removed as an out-patient procedure. You are not foreclosing your options for reconstruction should you change your mind in the future.

Eric Wright, MD Little Rock, AR
5 months ago

Expander removal can be performed as an outpatient procedure at any time. Expanders can be placed completely beneath the muscle, partially beneath or on top of the muscle. I would follow up with your surgery to discuss your concerns and desire to have the expanders removed. Your surgeon can discuss this process based upon your original surgery. If in the future you decide to move forward with breast reconstruction, you have several options. Good luck with your ongoing recovery.

Hello, thanks for your question. If you have decided against reconstruction, the expanders can be removed. Have they been filled up with saline yet? If so, you can discuss removing the saline now with your surgeon, to let you see how it would look and let your tissue recover a little before surgery.

The expanders can be removed easily but should be done in a sterile setting in the operating room. I usually recommend full anesthesia for patient comfort. The expanders are removed and a drain is placed. It should take about an hour and cause minimal pain. Drains usually stay in for 1-2 weeks. Also I would consider this part of your reconstruction so it should go through your insurance. Best wishes to you.

Nelson Castillo, MD Atlanta, GA
5 months ago

Thank you for sharing your excellent question. Some patients do elect to defer on reconstruction after their mastectomy and with tissue expanders in place, the only procedure required would be to remove them and any ancillary tissue used during their placement. Hope this helps.


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