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Topic: Tissue expander removed due to infection

Forum: Breast Reconstruction — Is it right for you? Discuss timing and various procedures and techniques.

Posted on: Mar 18, 2009 10:38AM, edited Mar 18, 2009 10:39AM by Alli

Alli wrote:

Hi,

My sister had BLM with immediate tissue expander placement on Jan 30th.  She initially had 4 drains and after 4 wks one drain remained due to high amt of drainage.  She developed a fever and redness and ended up having to have the TE removed and is currently having the wound packed twice a day.  Has anyone else experienced an infection requiring removal of TE?  The PS said he would want to wait at least 3 months before starting the process over.  Her remaining side looks great but she has put her fills on hold for now.  I am just worried that she will continue to have problems even if a new TE is placed. 

Thanks,

Alli

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Posts 1 - 24 (24 total)

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Mar 18, 2009 01:23PM swest wrote:

Alli -  I am not speaking from experience but from what I have read it is possible to have a successful tissue expander placement 3 months down the line.  I'm sure someone will respond who has had this experience.  Good Luck to your Sister!  I hope everything goes smoothly from here on out!

Dx 10/22/2008, IDC, 2cm, Stage Ib, Grade 3, 0/3 nodes, ER-/PR-, HER2-
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Mar 18, 2009 02:42PM dani42 wrote:

If you go to the february surgery thread, 2new1's just went through having to have her expanders removed.  She is just going through it so perhaps your sister would like to sign on to this site and talk with others. going through this experience.

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Mar 18, 2009 04:09PM Charlotte27 wrote:

Hi Alli,

May 2008 I had a bilateral mastectomy with reconstruction.  I went home with two drains.  Ten days post op I developed a fever and redness of my right breast which is where I had the cancer.  I responded to antibiotics and got better.  When they pulled the drain on the right side I gushed alot of the yellow drainage.  I think the drain had gotten plugged up a bit which was a great medium for bacterial growth.  I started chemo on July 11th and became very neutropenic and was running a low grade fever. I was still going for fills during chemo when the nurse noticed my right breast was looking a little red.  I also was not feeling well.  Went to see an infectious disease doc who said the tissue expanders had to come out.  The docs would not administer chemo while infected.  They were removed August 2009.  When I came out of surgery I felt so much better.  I finished my chemo and had the expanders reinsterted October 30, 2008.  Went for expansions without any problem and had my exchange surgery Jan. 30, 2009.  I had 550cc hgih profile mentor silicon implants inserted and they came out great.  I felt bad when the tissue expanders had to come out.  I wore prostheses in my bra during that time but hated how I looked without any boobs.  I was afraid I might not be able to get those expanders in again even though it was so comfortable to be without them.  I haven't decided what to do about nipples.  After having 4 surgeries in 8 months I feel I need a break.  Please tell your sister to be optimistic and persistent and in time she will be able to continue with the reconstruction. I also have a friend who had to have her expanders removed and had to be on IV antibiotics for 6 months.  She now has her expanders reinserted and is going thru expansion without any problem.  Good luck.

Dx 4/2/2008, IDC, 1cm, Stage IIa, Grade 1, 1/22 nodes, ER+/PR+, HER2-
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Mar 18, 2009 06:55PM roseg wrote:

I think your sister is probably really bummed out right now. Humor her!

My PS said a six month wait if anything went wrong, so 3 months is shorter. The time will go by, it may just not seem that way to her right now.

Rose

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Mar 18, 2009 10:24PM 2new1s wrote:

Alli ~ Sorry to hear that your sister is going through this.  Just a quick history of my surgeries:  bilateral mastectomy 2/11/09, emergency debridement (removal of dead skin that did not heal from surgery) surgery 2/26/09, and then just last week 3/8/09 - I had to have an emergency surgery in the middle of the night to remove my infected expander.  I had developed a horrible staph infection and they could not leave my right expander in.  However my left one looks amazing!  My PS said that she is hopefully looking to replace the expander perhaps sooner than three months as long as I am healed well by then.  Please send me a private message if you have any questions you want to ask me.  I check on this site everyday.  Prayers and hugs for you and your sister!  She is very lucky to have you looking out for her! 

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Mar 30, 2009 02:40PM KarenT66 wrote:

I just had my right expander removed on March 26. I had a right mastectomy on Jan 26 and developed an infection with a high temperature in February. They kept me on IV antibiotics for two weeks and then oral for 20 days. The minute I went off the antibiotics I noticed my right breast was red and went to my doctor. They had to remove the expander and I was so upset. But now after only 3 days I feel so much better. I didn't realize how bad I had been feeling with the infection and the expander. I won't be able to get a new expander until after chemo and look incredibly lopsided. But at least I feel sooooo much better with it out and could't imagine going thru chemo feeling that bad with the expander. It is just another detour on this cancer journey.

Dx 12/16/2008, IDC, 3cm, Stage IIa, Grade 3, 0/4 nodes, ER+/PR+, HER2+
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Mar 30, 2009 08:00PM mybeautifulsister wrote:

Hi Alli,

My sister also had to have her expander removed after 5 weeks, she wouldn`t stop draining and had a bad infection, she also had to have the packing.Then she started and finished her  Chemo in Nov. and 4 weeks ago they just put the espander back in, she had the drain removed last week but has gone every few days since to be drained with a needle extraction, they extracted 200cc`s today, her body just doesn`t absorb the fluid. It is really heartbreaking for her, she wants a breast SO bad!!!  Hopefully she won`t loose this one also!!! I will keep my fingers crossed for your sister.

It is hard watching our sisters be so disappointed  with all they have gone through!!!

Thanks,

Deb

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Mar 30, 2009 08:37PM ehall wrote:

Hi Allie--I know that your sister is terribly disappointed.  I too had a similiar experince and after 4 weeks developed an infection in my left (BC) expander.  It was emotionally devastating for me.  I was adament about throwing an arsenal of antbiotics at it but nothing worked.  After having it removed--I waited 8 weeks and had it reinserted.  It's been a year and all is well.  Time is great healer.  Take care--Erin

Dx 7/6/2007, DCIS, 4cm, Stage 0, Grade 3, 0/6 nodes, ER+/PR+
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Apr 6, 2009 07:09PM PinkChic07 wrote:

Hi Alli,

I too got an infection.  My journey goes like this--Bi lateral masectomy on 8-31-07 with immediate reconstruction with tissue expanders.  During a follow up visit a few weeks later, my PS noticed the left expander (the side w/the cancer) has shifted up so I had revision surgery on 10-2-07.  A week later it had shifted once again!  I had revision surgery once again on 10-22-07, spent the night at the hospital, went home the next day & got a fever that night.  Returned to see PS and I had gotten an infection.  I was re-admitted on 10-25-07 & my expanders (both of them infected) had to come out.  I started chemo on 11-4-07 and nothing could be done during that time, and my PS said they would have to stay out a minimum of 3 mos.  After healing though, I had the expanders put back in on 3-13-08 with no problems at all.  I did my fills until 7-8-08 and had my exchange to silicone high profile implants on 8-14-08, no problems there either other than some tape irritation that sent me back to the hospital for iv antibiotics.  My PS didn't want to take ANY chances when he saw a little redness, turned out to be only tape irritation.  Tell your sister to hang in there, I know how she is feeling, I too so wanted to have breasts thru the whole process of chemo.  She is welcome to PM me if she wants any other info or just to vent to someone who has been there. 

Trina

Dx 8/2007, IDC, 1cm, Stage IIa, Grade 2, 3/30 nodes, ER+/PR+, HER2-
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Apr 22, 2009 07:47AM michelep wrote:

  Just last week I had to have my r tissue expander removed after 6 weeks. One year ago i had a   L  mastectomy  after several months of chemo,  then radiation after about a month.  I was so looking forward to the B lat. reconstruction   I never thought I would have a problem with the prophylactic side.  There was a large area of necrotic tissue along the incision .  After about 2 weeks I went back to the hospital for  IV antibiotics for four days, then 10 days of oral antib. It looked better and the ps planned to excise  the eskar  after a couple more expansions.but two weeks later I had emergency surgery to remove the dead tissue and unfortunately the expander had to come out too   and again the IV and oral antibiotics.  The ps says I have to wait at least 3 months before any more surgery.  I am very dissappointed and wonder if the dead tissue had been removed sooner if the expander could have been saved......

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Apr 22, 2009 08:02AM REKoz wrote:

Hey Michelle-

I'm just curious having gone through that dead tissue/infection issue myself. Fortunately, I was able to save the expanders but have to wait through chemo for revision and THEN fills. Did you say you were filled with that dead tissue in place? That would be highly unusual I think?

Ellen

BMX 11/08, Abraxane/Carbo/x4 1/09 Herceptin until 1/10, Recon w expanders-1st exchange Dec. 09. Revision from 700 Style 20 to 600 Style 45-Oct 10

Dx 10/16/2008, IDC, 1cm, Stage Ib, Grade 3, 0/5 nodes, ER+/PR+, HER2+
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Jan 6, 2011 05:18PM Ruthlo wrote:

After bilateral mastectomies I had tissue expanders placed.  The right side got infected and I had to have the expander and the alloderm removed.  Now the scar tissue from the incision is adhered to my chest wall.   Has anyone been in this situation?  Any advice?  I was told by my PS I would have to wait until it loosened to have the expander replaced.

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Sep 25, 2011 07:02AM debbiey wrote:

how did things go for you regarding your scar tissue being adhered to chest wall. I have just had to have my tissue expander removed due to an infection andam so disappointed. I am desperate to get rid of the infection. I am on strong antibiotics but the scar is still oozing. I thought that would all stop once the expander was remover. It was removed on Thursday 22nd September after being in 4 weeks.

Dx 11/3/2010, IDC, 4cm, Stage IIa, Grade 3, 0/3 nodes, ER+/PR-, HER2+
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Sep 25, 2011 11:39AM SpecialK wrote:

debbiey - there is another thread called TE TROUBLES, post there and the ladies will chime in for you.  We have all had, or are having, problems with our TE's, so it is a group very familiar with your situation.

Dx 9/27/2010, DCIS, Grade 3Dx 9/27/2010, IDC, 2cm, Stage IIb, Grade 3, 2/14 nodes, ER+/PR+, HER2+Surgery 11/01/2010 Mastectomy (Both); Reconstruction: Tissue expander placement (Both)Surgery 12/06/2010 Lymph Node Removal: Axillary Lymph Node Dissection (Right)Surgery 12/21/2010 Reconstruction (Left)Surgery 01/07/2011 Reconstruction (Left)Surgery 01/21/2011 Reconstruction (Left)Chemotherapy 02/17/2011 carboplatin, TaxotereTargeted Therapy 02/17/2011 HerceptinSurgery 07/20/2011 Reconstruction: Tissue expander placement (Left)Hormonal Therapy 08/01/2011 FemaraSurgery 02/24/2012 Reconstruction: Breast implants (permanent) (Both)Hormonal Therapy 06/20/2012 ArimidexSurgery 12/14/2012 Reconstruction (Both)Hormonal Therapy 07/18/2013 FemaraSurgery 03/07/2014 Reconstruction (Both)Surgery 04/02/2014 Reconstruction: Breast implants (permanent) (Left)
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Sep 25, 2011 02:05PM debbiey wrote:

Thanks Special K have posted a message on TE troubles. Thanks for help. Just knowing others have suffered the same  and got through it helps. You do feel have I not suffered enough. Could you not just give me a easy ride with my reconstruction. People saying it will make me stronger who have never had BC or a reconstruction irritate me as they dont have a clue what it is like.  

Dx 11/3/2010, IDC, 4cm, Stage IIa, Grade 3, 0/3 nodes, ER+/PR-, HER2+
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Sep 27, 2011 01:37AM WhitneyV wrote:

I was tested for the Breast Cancer gene and tested positive in May of 2011.  I had a prophylactic double mastectomy in June 2011 and have had many problems with the tissue expanders.  My left side has been replaced twice and my right side is original.  I have had multiple infections on the left side and currently do not have an expander on the left.  Ive been on antibiotics for 10 of the last 12 weeks.  The infections were different each time, nonetheless, the expanders had to be removed.  I was really bummed when it was removed last week for the second time, but gained new perspective that this journey is but a year of my life and in that perspective, I am less frustrated. 

What I would like to find out is why we are all getting these infections.  Is it the material the TE are made of?  Are they allergic reactions that our bodies are overcompensating for?  What is actually happening?  I have had 5 surgeries in the past 3 months, and have several more I'm sure before my reconstruction is complete.  Has anyone researched the root cause of the infections?  Or the material the TE are derived from?

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Jun 15, 2012 02:06AM SusieR12 wrote:

Hi Ali,

 My mastectomy surgery was May 7th and had the TE place at the same time...4 weeks later i had to have my incision redone due to my skin being to thin and not healing...6 weeks later my new incision began to open with some sort of drainage...I went into to the see the PS and he drained a whole lot of yellow stuff out and I had enourmous relief from pain after the drain...He sent off a sample to be tested for infection and placed me on Cipro antibiotic...My incision looks good after just two days but the drainage has filled up so fast and needs to be drained again...Don't see the PS until next week which is 5 days away and so afraid the buildup of drainage will cause my incision to not heal and open even more...PS says if its infected and Cipro doesn't help then I will have to have TE removed and start over a few months down the road...Sometimes i wonder if all this hassle, doctors appts., and pain is worth it...Hope your sister is doing well by now!!!

Surgery 05/07/2012 Mastectomy (Left); Reconstruction: Tissue expander placement (Left)Surgery 06/02/2012 Reconstruction: Tissue expander placement (Left)Hormonal Therapy 06/13/2012 ArimidexSurgery 06/29/2012 Reconstruction: Tissue expander placement (Left)Surgery 08/21/2012 Reconstruction (Left)Hormonal Therapy 05/16/2013 Tamoxifen
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Jun 19, 2012 12:45PM joburt1 wrote:

Hi Allie,

I feel your sister's pain.  I do hope all went well for her (your post is dated 2008 so I wonder how she made out).  I too had to have both TEs removed due to a severe infection on my right side.  My PS wanted to wait 6 months to heal as the bacteria was resistant to oral antibiotics, so I am currently on an IV administered antibiotic for 6 weeks.  I was told we could look at starting reconstruction over again in August 2012.  My fear is that the antibiotic may not get totally rid of the bacteria and that I'll be on the IV longer.

  My PS said he may put me on a prophylactic regimen of IV antibiotics before, during and after the TEs are put in and during the fills.   He will discuss with my infectious disease doctoer for next steps.  However, I don't know how they'll administer the antibiotic.  Right now I have a cathetar (couldn't do a picc line because the BLM was too close to the bone).  I have to wonder if another cathetar would be in the way of the TE?  I won't know more until mid-July.

I hope your sister made out well.

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Jul 29, 2012 02:17AM, edited Jul 29, 2012 02:30AM by Hart418

Hi Ruthlo, I am in that situation right now as my breast skin adhered tightly to my rib cage,  and I am wondering what to do and where to go for help. What have you done since your last posting? I am doin physical therapy and that is helping loosen things up by My PS told me my 1st option was to do nothing, that is unacceptable I was counting on him to help make me whole after going thru this damn cancer. Any help or ideas would be so appreciated by anyone. I am seeking a 2nd & 3rd opinion. Melody

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Feb 12, 2013 09:07AM dnadebbs wrote:

i know this topic hasn't been looked at for a while but i'm goign thru this right now.   I had a TE recon on 1/3.....a week later i developed an infection on the radiated side......a week after that it spread to the other side........a week after that i was admitted to the hospital from my dr's office and the next morning she removed both the TE's.   it's been 2 weeks now and the radiated side is still red, swollen and painful at the touch.     I've been on antibiotics since 1/3 and nothing is helping.  i'm calling my PS today to let her know they are still not working and we probably need to figure something else out.   i've researched online what to do but haven't really found anything about what to do when your TE's are removed and you STILL have the infection!     has anyone gone thru this?   can anyone give me some insight?

thank you so much!

ally

Dx 10/2011, LCIS, 4cm, ER-/PR+, HER2+Dx 11/2011, DCIS, ER+Targeted Therapy 11/03/2011 HerceptinChemotherapy 11/03/2011 Cytoxan, TaxotereSurgery 03/20/2012 Mastectomy (Both)Radiation Therapy 05/08/2012 ExternalHormonal Therapy 09/10/2012 Tamoxifen
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Feb 13, 2013 09:26PM Binc wrote:

Dnadebbs - I had my tissue expander removed over the summer due to infection. My surgeon left the surgical incision open and I had to pack the open wound as it slowly closed over the next 6 weeks. I remained on antibiotics for 1 week post surgery. When it finally closed, the infection flared up again. I took zyvox (a very potent oral antibiotic) for a little over 2 weeks and the infection finally cleared. . .

I had the tissue expander put back in last month and developed another infection. I had a picc line put in and was on IV vancomycin for 2 weeks. Again, the infection seems to have cleared, but time will tell. IV antibiotics are more effective than oral ones. Your doctor may want to consider that?

If you go to the TE trouble thread, you will find many women who have been in your situation. There is great support there. Good luck!

Dx 9/29/2011, IDC, <1cm, Stage Ib, Grade 3, 0/2 nodes, ER+/PR+, HER2+Surgery 11/07/2011 Mastectomy (Both)Chemotherapy 12/14/2011 TaxolTargeted Therapy 12/14/2011 HerceptinSurgery 04/23/2012 Reconstruction: Tissue expander placement (Both)Surgery 07/17/2012 Reconstruction (Right)Hormonal Therapy 01/03/2013 TamoxifenSurgery 01/08/2013 Reconstruction: Tissue expander placement (Right)Surgery 10/18/2013 Reconstruction: Breast implants (permanent) (Both)
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Feb 14, 2013 06:55AM dnadebbs wrote:

thank you so much Binc!   wowzers!   i didn't even know they could leave it open....what an ordeal you went thru!  thank you for the information......i'm at my wits end with this infection.  it's not open at all just swollen and red and very tender......i always think the worst.   i'm glad you added that you actually tried the process again and even tho you developed the infection  again.....they were able to get rid of it and so far so good.   i wish you well!   i'm scared to do it again but i know i will.   i've read about how sooo many women have not given up and tried and tried again and are happy they did in the end.   so i will truck on too.

reading your history.....looks like you were alot like me.   going thru the same things around the same timeframe i did.   i pray everything continues to go well for you.........

much love!

ally

Dx 10/2011, LCIS, 4cm, ER-/PR+, HER2+Dx 11/2011, DCIS, ER+Targeted Therapy 11/03/2011 HerceptinChemotherapy 11/03/2011 Cytoxan, TaxotereSurgery 03/20/2012 Mastectomy (Both)Radiation Therapy 05/08/2012 ExternalHormonal Therapy 09/10/2012 Tamoxifen
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Feb 14, 2013 07:10AM SpecialK wrote:

dnadebbs - you might want to consult an infectious disease doc - they are the specialists in infection and how to clear it, but it sounds like you may need some IV antibiotics.  Also the area might need to be cultured for exactly what kind of infection so the correct drugs are used to clear it - some infections are bacterial and some can be fungal, some can be both.  Good luck!  The TE Trouble thread if full of ladies who have had these issues - I linked it for you.

http://community.breastcancer.org/forum/44/topic/771702?page=186#idx_5576

Dx 9/27/2010, DCIS, Grade 3Dx 9/27/2010, IDC, 2cm, Stage IIb, Grade 3, 2/14 nodes, ER+/PR+, HER2+Surgery 11/01/2010 Mastectomy (Both); Reconstruction: Tissue expander placement (Both)Surgery 12/06/2010 Lymph Node Removal: Axillary Lymph Node Dissection (Right)Surgery 12/21/2010 Reconstruction (Left)Surgery 01/07/2011 Reconstruction (Left)Surgery 01/21/2011 Reconstruction (Left)Chemotherapy 02/17/2011 carboplatin, TaxotereTargeted Therapy 02/17/2011 HerceptinSurgery 07/20/2011 Reconstruction: Tissue expander placement (Left)Hormonal Therapy 08/01/2011 FemaraSurgery 02/24/2012 Reconstruction: Breast implants (permanent) (Both)Hormonal Therapy 06/20/2012 ArimidexSurgery 12/14/2012 Reconstruction (Both)Hormonal Therapy 07/18/2013 FemaraSurgery 03/07/2014 Reconstruction (Both)Surgery 04/02/2014 Reconstruction: Breast implants (permanent) (Left)
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Feb 14, 2013 07:24AM dnadebbs wrote:

thank you sooo much!  i actually just shared my issue on that thread as well.   someone else said that i should suggest they find out exactly what type of infection it is so it can be treated correctly.   i plan on talking to her about all that.   thank you so much again.....i sooo appreciate your help!

ally

Dx 10/2011, LCIS, 4cm, ER-/PR+, HER2+Dx 11/2011, DCIS, ER+Targeted Therapy 11/03/2011 HerceptinChemotherapy 11/03/2011 Cytoxan, TaxotereSurgery 03/20/2012 Mastectomy (Both)Radiation Therapy 05/08/2012 ExternalHormonal Therapy 09/10/2012 Tamoxifen