Category Archives: Expansions

Fifth expansion

WARNING: NSFW / graphic content below.

In other news: I had my fifth expansion. 50ccs have been added to each expander, for a total of 400ccs/side. We’re getting there.

184ccs vs. 400ccs

184ccs (pre-op) vs. 400ccs

I am very happy with how these things are looking so far. Compared to how expanders usually look on women, mine have a pretty natural shape. A bit lop-sided, with righty higher up than lefty, because of how the internal pockets healed post-op. The right pocket closed up a little bit on the bottom, so the expander sits higher in my chest, but it’s not too bad. This will be fixed during the exchange surgery in September.

I have a few more decisions to make before September. Mainly: will I get silicone or saline implants, what shape will they be, and what am I going to do about my nipples. If you’ve been following me for a bit (or can tell from the photos), you know that I lost one of my nipples to necrosis. I need to figure out what I’m going to do about it. The options are:

  • Nothing
  • Reconstruct the lost nipple via skin graft or skate flap
  • Get a 3D tattoo
  • Remove the other nipple

I can’t decide what is best. On one hand, I went through all this trouble, so why give up now, but on the other, I just don’t think I’m going to like the aesthetic result if I do nothing or reconstruct/tattoo just one. What’s more awkward than two hard nipples? ONE! I like symmetry. I think I’m going to remove the other one and maybe reconstruct them both. Not 100% on that though. We shall see.

Here are the pics. Big difference between what 100ccs looked like after my mastectomy in January and the 400ccs I have today.

2013_5_24 fills

100 + 50 +75 +75 + 50 + 50 = 400ccs

Fourth expansion

WARNING: NSFW / graphic content below.

Another fill behind me. We took it back down a notch from 75 and added 50ccs to each expander, for a total of 350ccs/side. I’m not sure that you can see much of the difference in the photo, whic is at the bottom of this post.

I must say that I feel better after this fill than I did after the previous three. Typically I wake up on Saturday and it takes me a while to get going. This morning I didn’t feel much pain at all – no ibuprofen needed. I went food shopping and cleaned the whole house. I hope I don’t regret this tomorrow! Fingers crossed that this continues for the next four fills.

To celebrate my over-the-hump expansion (four down, four to go), I present to you: t-rex. In a previous post (see: Shower time) I joked that I had t-rex arms because of my limited range of motion right after the mastectomy. I could barely scratch my head (or butt) for a few days. I got this shirt shortly after. Enjoy!

Ask me about my t-rex

2013_5_10 fills

100 + 50 +75 +75 + 50 = 350ccs

We’re getting there – third expansion

WARNING: NSFW / graphic content below.

Fill number three is done.  We added 75ccs to each expander, for a total of 300ccs/side (pic below). It is about the same on the pain scale as it was last time – nothing initially, but feeling pressure the next morning. I continue to slather these things with cocoa butter oil with vitamin E to keep the skin soft and prevent stretch marks. So far so good. If you missed the scoop on the first two fills, see: They’re growing and They’re back.

Since I still haven’t decided just how big I want to go, while I was in for the fill I checked in with my plastic surgeon to get his feedback (I trust that he has an eye for these things). Another 150ccs or so will be just right based on my body size and shape. Ultimately, it is up to me how many ccs will be the sweet spot, but I do agree that we’re not there yet. So we are going to continue the fills until I’m happy. What then?

Once the desired size is reached, there are two more 50cc fills done. As you see in my photos, the tissue expanders are kind of boxy and sit high up on the chest wall. The additional expansions are done to overstretch the skin and muscle, so that when the final implant is placed it has a more natural shape. When the expansions are done, we wait four to six weeks before we move on to the next step.

Exchange surgery

When we’re done will all of the fills, including the overfilling step, an exchange surgery is performed. This is an outpatient procedure during which the plastic surgeon exchanges the tissue expanders for saline or silicone implants.

I asked how far out they are booking surgeries for Dr. M and quickly realized that I need to get something on the books STAT. The first available date is September 3rd. That is over four months away!!! My (sarcastic) thanks to Dusky, my rebel left nipple. Had I not experienced necrosis (see Tissue necrosis), we would’ve started the expansion process about two months sooner. What can I do about it? Be grateful that necrosis was as bad as it got.

Current plan: three more 50cc expansions + two 50cc expansions to overfill = 550ccs. Here’s to a Dolly Parton-esque summer! Not sure if this is good or bad. Thoughts? I’ll be celebrating my last expansion with July 4th fireworks. On this day last year, I was struggling to enjoy myself while hanging out with friends at the beach. I didn’t get the call that was supposed to come on July 3rd – the results of my biopsies. I spent July 4th entertaining thoughts of tumors, cysts, breast cancer, chemo, and worse, rather than enjoying fireworks and my friends. It was a really bad day. What a difference a year makes.

Anyway, watch my boobs grow!

Fills 2013_4_27

100 + 50 +75 +75 = 300ccs

They’re back – second expansion

WARNING: NSFW / graphic content below.

Another expansion done! We added 75ccs to each expander, for a total of 225ccs/side (pic below). I am now just a tad over my size before the prophylactic bilateral mastectomy in January.

I decided to speed things up a little bit – rather than doing 50ccs per expansion, we bumped it up to 75ccs. So far, so good, but it has only been a few hours. The worse of the pain the first time hit me when I woke up on the day after the fill. I felt like I was back in the recliner the first week post-op. I popped an ibuprofen, did some stretching, and moved on with my day. The pressure eased as days passed and I was back to “normal” within a week. Well, here we go again. I imagine it will get worse with each fill, but we shall see.

Breast Reconstruction Guidebook Figure 7.1For a recap of why/how the expansion process works, see They’re growing or check out the video below, which was shared by fellow PBM-er Trisha on her blog I’m getting my boobs chopped off. By the way, if you haven’t noticed, I list a number of blogs on the right side of the page under Relevant Sites & Blogs. Check them out! Most of those ladies has also undergone a mastectomy; some proactively and some after a breast cancer diagnosis.

fills-2013_4_12

100 + 50 + 75 = 225ccs

Source of Figure 7.1: Steligo, Kathy. Breast Reconstruction Guidebook: Issues and Answers from Research to Recovery. Maryland: The Johns Hopkins University Press, 2012. Print, third edition.

They’re growing – first expansion

WARNING: NSFW / graphic content below.

Goodbye ugly scab, hello first fill!

The scab that has been living on my left boob has finally fallen off! Can I get a “woo hoo”? It has been two full months since my prophylactic mastectomy on January 22 and the start of my adventure with resulting skin/nipple necrosis. Today I had my first fill. 50ccs of saline were injected into each tissue expander, bringing the total to 150ccs/side.

Tissue expanderWhat are tissue expanders, you ask? The type of breast reconstruction I chose is two-staged: tissue expanders first, followed by silicone breast implants. The tissue expanders, which were implanted underneath my pectoralis major muscle during the mastectomy, get filled with saline on a regular basis to stretch said muscle and the skin that covers it, until the desired volume is reached. They are like “pre-implants.” Similar shape, but more rigid, unnatural, and uncomfortable. They have a round magnetic port in the top half, which allows for insertion of a needle, without compromising the expander.

Breast Reconstruction Guidebook Figure 7.1

The process of filling the tissue expanders is pretty quick and uneventful. First the nurse uses a little plastic contraption with a metal pin at the end to find the magnetic port in the tissue expander. Once the center of the port is identified, the nurse sanitizes the area and injects the needle attached to a syringe holding the saline. She then slowly pushes the plunger until all 50ccs of fluid have been injected into the expander. This takes less than one minute. After completing the fill, she places a little round band-aid over the injection site. Same story on the other side.

This procedure is overall painless (based on just the first fill). The only sensation was a brief sting as the needle was inserted into the port through the skin.Three hours later, I feel a little bit of that now-familiar pressure on the muscle and skin stretched over the expanders. As soon as I got home, I popped an ibuprofen, did some stretches, and smeared my chest with Palmer’s cocoa butter oil.

As I look down at my chest, I can see that my foobs are bigger. It is a small difference, but it’s there. It will be interesting to watch these things grow. I can already tell that it won’t be pretty. The expanders didn’t settle exactly the same way: one sits higher and the other one is a bit twisted. The asymmetry seems to be normal based on my plastic surgeon’s feedback and the photos other women have shared. Enjoy the visual!

Fills 2013_3_29

100 + 50 = 150ccs

The fills will continue every two weeks at 50ccs/side. At this point, I have not yet decided how big I want to go (one of my friends joked: “go big or go home!”). However, I did find out that my breast surgeon removed 184 grams of breast tissue/side, which translates to roughly 184ccs, so one more fill and I will be back to pre-op size. Next appointment: April 12.

Source of Figure 7.1: Steligo, Kathy. Breast Reconstruction Guidebook: Issues and Answers from Research to Recovery. Maryland: The Johns Hopkins University Press, 2012. Print, third edition.