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Topic: Hollow area above expander

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

Posted on: Feb 2, 2009 12:33PM

CrystalLocket wrote:

I had a bilat mast on the 21st and on the side that didn;t have the cancer, it seems like they maybe took more tisssue?  It is a hollow area above the tissue expander between my collar bone and breast.  Is this normal?  Does it go away? and is there anything the PS can do to make it better?  Anyone know of a site with before and after pictures of those with this problem?  TIA

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Posts 1 - 19 (19 total)

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Feb 2, 2009 12:47PM monee wrote:

I have the exact same problem. I am hoping it could be fixed during exchange surgery. I don't see the PS until March though.

Dx 6/6/2008, IDC, 1cm, Stage II, Grade 2, 1/10 nodes, ER+/PR+, HER2-
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Feb 2, 2009 12:52PM JustTurnedForty wrote:

I believe this is pretty normal with expanders.  The final implants will look different, and usually a high profile implant is used to fill that in.  Be sure to talk to your PS about it. 

Janine, who is now 43 Dx 1/15/2007, DCIS, Stage 0, 0/3 nodes, ER+/PR+
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Feb 2, 2009 12:58PM fogandroses wrote:

Hi Karen,

I'm glad you asked this question. I've been meaning to post myself.  I have exactly the same thing - a drop off between my collar bone and the top of my implant.   It's been there from the beginning and only on my prophy (left) side. My BC side has a nice smooth slope to it.  I haven't asked my PS about it yet. Just focused on everything else I guess. I had exchange surgery from expanders to silicone implants 1/21 and it's still quite pronounced. Other than this, I'm extremely happy with my recon.

Do you have any pain on that side?  Mine is sensitive to the touch and gave me major pain during the expansion process.  My right side never bothered me at all.  My theory is that the surgeon took out too much on the left side!  I have a post op appt. tomorrow and that's on my list of questions. 

I'm really interested to hear from others who might have the same thing.  Hugs, Lisa

Dx 6/2008, DCIS, Stage 0, Grade 3, 0/2 nodes, ER+/PR+, HER2-
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Feb 2, 2009 01:08PM fairy49 wrote:

Hi guys, I think its because the expander isn't as far up under the chest muscle as the other one, my bc side has a nice "shelf" the other side as a bit of a drop off which has got better with each fill, however PS explained that with TE's sometimes they don't match as to where they sit under the muscle (rectified during exchange!) Hope that helps!

Lorraine ox

DX 9-22-08 IDC 1.1cm Stage 1 Grade 2 SNB 0/5 ER+ PR+ HER- Bi-Lat Mas re-con,tissue expanders on 10/29 - Exchange to silicone implants on 3/6/09 Oncotype DX Score 9 - BRCA 1 & 2 Negative.....If God brings you to it, he WILL get you through it
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Feb 2, 2009 02:03PM fogandroses wrote:

My exchange surgery didn't fix the problem so for me it wasn't related to the TE's.  My bilat mx was done at a cancer center/teaching hospital.  I have this nagging thought that maybe a less experienced surgeon did the prophy side.  Someday I'll request the surgery notes but I'm not ready to see them yet...

Regardless of why it happened, I'm sure something can be done to fill in the hollow. Will find out tomorrow!

Dx 6/2008, DCIS, Stage 0, Grade 3, 0/2 nodes, ER+/PR+, HER2-
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Feb 2, 2009 02:07PM CrystalLocket wrote:

That's really interesting...mine was also done at a teaching hospital.  I will ask the PS when I see him on Thursday and let you all know.  I would like to wear strappy tops again someday, but I don't think I'll be able to with this dent.  It is pretty bad.

Karen Dx 11/24/2008, ILC, 1cm, Stage IIA, Grade 2, 1/11 nodes, ER+/PR+, HER2-
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Feb 2, 2009 02:14PM fogandroses wrote:

Thanks, Karen.  I'll check back to see what you find. My PS appt. is tomorrow afternoon so I'll update here also.

Dx 6/2008, DCIS, Stage 0, Grade 3, 0/2 nodes, ER+/PR+, HER2-
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Feb 2, 2009 04:54PM Jeansbeans wrote:

Karen, I too have the same problem, My exchange is in 2 days my PS is going to lipo suction fat from my belly to fill in the gaps!  I have to say I am a little excited to get rid of the little belly I've had since I gave birth 32 yrs ago!! Ask your PS what he can do for your problem.  Good luck. It seems we all share the same problems one way or the other. Gentle Hugs, Jeanie

Dx 5/12/2008, IDC, 1cm, Stage I, Grade 1, 0/4 nodes, ER+/PR+, HER2-
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Feb 2, 2009 06:11PM soccermom96 wrote:

I have the same thing....practically a shelf on the cancer side. The TE on the prophy side rotated a bit so it looks more "normal" at the top but is square on the side.  PS says he will fix it @ exchange and that the implant (being round) will take up more space and my chest wall will slope evenly.  I sure hope so since he doesn't think he can do a whole lot with the cavern that is now my armpit from the SNB! 

Fogandroses---I didn't know you could request surgical notes. Do I want to read them?  Hmmmm.... I was convinced two different people had sewn my mastectomy scars but one side had more skin than the other.  They evened out at last expansion and now look identical. 

Dx 9/8/2008, DCIS, Stage 0, Grade 3, 0/2 nodes, ER+/PR+
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Feb 3, 2009 05:12PM mawhinney wrote:

You can request reports of all your surgeries, tests, treatments etc. I always get a copy so that I have a record.

 I had a mastectomy with implant reconstruction.  I have a hollow above the implant.  A tissue graft was placed near the top corner of the implant in hopes that new tissue would grow and fill in the area.  PS said he could try fat injections but the success rate is only 30-50%. With the low success rate plus having another surgery. I declined the fat injections.

Dx 5/18/2008, IDC, <1cm, Stage IB, Grade 2, 0/1 nodes, ER+/PR+, HER2-
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Feb 3, 2009 06:11PM AnneW wrote:

I have the same thing, both sides, as bad after the exchange as before it, and with smaller size, too.

Anne

2002 IDC stage 1, grade 1, rads & AI Dx 9/18/2007, ILC, <1cm, Stage I, Grade 1, 0/1 nodes, ER+/PR+, HER2-
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Feb 4, 2009 04:50AM fogandroses wrote:

I had my post op yesterday (exchange was 1/21).  I asked about fixing the hollow area and he said he didn't recommend fat injections because that could cause "lumps".  He also said that because I am thin I am actually lucky that the hollow area isn't worse and only on one side.  He wants me to take a year with no surgeries to heal and then come see him to discuss nipple recon and the hollow area.  I have huge respect and admiration for my PS so will take his advice. 

Lisa

Dx 6/2008, DCIS, Stage 0, Grade 3, 0/2 nodes, ER+/PR+, HER2-
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Feb 4, 2009 03:55PM PhyllisCC wrote:

I have the hollow area too. I called it a collapse and my PS referred to it as a divot. It was there with the expander and was still there after the exchange.  I was very self conscious about it.  I had a rt mast and we just wanted to match my good side.  Most people thought the hollow was a shadow.  I went back for revisions in Oct 08.  My PS placed alloderm at the top to help.  Initially it looked really good. However, the hollow has returned but not as bad (or maybe I'm used to it) I also have slight rippling at the top, too.  My PS does not recommend the fat injections for those dx with BC.  She says they don't always work and can leave lumps and we don't want more lumps to worry about.  My skin is very thin from the mast. Additionally my muscle does not come down far enough so I am dealing with two distinct points at the bottom where the implant pokes thru.  So I wait...at least another 6 months.  My PS may use alloderm at a later date to help fix the bottom part.  Dressed I look just fine, undressed not so good. However the nip and tattoo turned out terrific...and actually draw the eye away from some the the "problem" areas.  And my one year check was all clear and that was the best news I could have received.  Has anyone had the hollow fixed and how? Phyllis

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Feb 4, 2009 09:01PM Nann wrote:

I have hollows above both breasts. My PS called them divots and told me before surgery that I would most likely have them.  He said it happened more frequently with saline implants, which I have, than with silicone.  It is more obvious on one side than the other, but I think it's more noticeable to me than to others.

Dx 4/10/2008, DCIS, 2cm, Stage 0, Grade 2, 0/2 nodes
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Feb 8, 2009 03:32PM Jeansbeans wrote:

HI, I  HAD  the same thing as you, Notice I said HAD,  I just had My Exchange done on WED. the 4th of Feb,  My PS  did liposuction from my belly and underarm to fill in the gaps. It LOOKS FANTASTIC!  I can't even tell there wes a defect!  Talk to your PS about this.  He should beable to fix the gap.  Good Luck to you .  Gentle Hugs!  Jeanie

Dx 5/12/2008, IDC, 1cm, Stage I, Grade 1, 0/4 nodes, ER+/PR+, HER2-
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Feb 11, 2009 10:57AM , edited Feb 11, 2009 10:59AM by susan13

I have hallows too, started out just on one side, now it's on both.  Saw my PS yesterday and he said he was going to try and fill in my cleavage... how ? I have no idea.  He did mention doing a fat graph? during my exchange. I don't like the sound of that. I posted a pic, cause u can see both of the hallows if I wear somewhat of a lowcut top.

Jeanie-did the liposuction make for a more recovery?  I'm thinking the exchange is going to be a piece of cake for me, seeing that it's supposed to be so much easier then the mast... but now I'm thinking not cause of these hallow things!

You can't change the past but you can ruin the present by worrying over the future. suesbadboobs.blogspot.com dd CAF bilat mast. w/recon. dd Txo. 25 rads. Tamoxifen.
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Feb 12, 2009 01:49PM pensacola wrote:

I did not have the hollow (concave) area with the tissue expander.  It was sitting high on my chest, substantially higher than my natural breast.  However, I am now 6 months post exchange and it is very noticeable.  Once my implant dropped into its final position I was left with a large dent in my chest from my clavicle to the top of the implant.  It looks as if I have a squishy ball under my skin with no slope whatsoever.  I also have ripples, especially pronounced when I bend over.  I have a 400ml mid-profile silicone implant, which is not quite a full B cup.  I was an A prior to breast cancer and had a small implant placed under my right breast in an effort to better match the reconstructed left (at the recommendation of my plastic surgeon; I never wanted to be larger than I was before).  I am small-boned and slender (5'3" and 111 pounds), and I am wondering if this is as good as it is going to get.  After all I have been through, I was hoping for a better outcome.  I look fine in clothes, but not so good without.  My plastic surgeon told me that it was because I have very little subcutaneous tissue, but I have seen photos of others who appear quite thin and have the slope of a normal breast.  My nipple reconstruction has also been a disappointment due to the lack of tissue to work with.  At 3 months post-op, it has almost disappeared into the surrounding tissue.  Any suggestions? Anyone out there with my body build who has better results?  I would appreciate any comments.  I exercise religiously, but have not been able to build up my chest muscles on the left side.

stage 1 idc, intermediate grade, multifocal dcis, intermediate grade, 0/1 node, est+/pr+ her2-

Pam Dx 3/13/2008, IDC, <1cm, Stage IB, Grade 2, 0/1 nodes, ER+/PR+, HER2-
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Feb 12, 2009 04:10PM PhyllisCC wrote:

Pensacola,

I answered on your other thread...  you sound like me.  Phyllis

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Feb 12, 2009 07:39PM hopefor30 wrote:

I don't have the hollow (had DIEP) but I had fat injections to get rid of it.    My nipple, however, has disappeared -- I had the tattoo done anyway, but the nipple is flat.

M.