Starting Reconstruction

My surgery to place the expanders has been scheduled for the first week in January. I will see the plastic surgeon twice before surgery. I love my surgeon and she is a survivor herself. Bring on the turtle shells. That's what the expanders look and feel like under the skin. We had show and tell at support group last night, so I got to see an actual expander that my surgeon placed. I am having a lot of fear about the pain involved with the expansion process. I think the experience is different for everyone and I've heard it all. I'm going for it and I'm excited to have scheduled the surgery. It's real now.

[Post mastectomy reconstruction with a tissue expander and implant involves a staged approach. A tissue expander is a temporary device that is placed on the chest wall deep to the pectoralis major muscle. The purpose of the expander is to create a soft pocket to contain the permanent implant. Placing the Expander - at the time of the initial post mastectomy reconstruction operation, when it is first positioned on the chest wall, the tissue expander is partially filled with saline. Within a few weeks after this surgery, once the patient has healed, expansion can be started as an office procedure. The process of expansion takes place at one, two or three week intervals over several months. The amount of fluid that is placed into the expander at the time of the initial surgery will also determine how many expansions are later required. Most expanders have a fill port that is built into the front of the device. This port is accessed with a needle through the skin. Expansion takes about one minute, and the amount of fluid that is placed is limited by the tightness of the patient’s skin. A typical volume for each expansion procedure is 50 cc's of saline (an equivalent of 10 teaspoons). Once expansion is completed and the patient is medically cleared for another operation the second stage of reconstruction is performed. This is an outpatient procedure that involves exchanging the expander for an implant, and creating a more refined breast shape. The initial tissue expander placement, and subsequent exchange for an implant, each take about one hour in the operating room.]