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All TopicsForum: Breast Reconstruction → Topic: Tissue Expander Fills... How often, how much?

Topic: Tissue Expander Fills... How often, how much?

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

Posted on: Jan 2, 2012 04:06AM

Josie4 wrote:

I had a Bilateral Mastectomy on 11/19. PS filled expanders with 200 cc's at time of surgery. I started chemo a few weeks ago. I'm scheduled for my first fill of 60 cc's this week. I'm not ready for a fill. My muscles have barely calmed down from surgery 7 weeks ago and I'm afraid that my muscles will tighten again after the fill. Since I'll only need 2-3 fills and I cant do reconstruction till June, is there a rush to do the fills?

Also, have any of you ladies experienced pain or major muscle tightening after the fills?


Dx 10/24/2011, IDC, 1cm, Stage I, Grade 2, 0/4 nodes, ER+/PR+, HER2-
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Jan 2, 2012 07:11AM sweetbean wrote:

Hi Josie,

I don't think there is a particular rush.  Have you asked your PS to give you a few more weeks?  I had my BMX on 4/13 and started fills three weeks later.  I had 90 cc's at each fill because we were rushing to get me filled so that I could start radiation.  The first 60 cc's were fine - a little uncomfortable, some tightness, but no big deal.  But every time, those last 30 cc's - yowza!  So painful - I was sprinting for the Vicodin!   Anyway, 60 cc's should be fine for you, but ask about waiting until you feel ready.   

Dx 11/18/2010, ILC, 5cm, Stage IIIA, Grade 2, 2/15 nodes, ER+/PR+, HER2+ (FISH)
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Jan 2, 2012 03:35PM ThisTooShallPass wrote:


I had original BMX on Nov 24, then complication revision expanders put in on Dec 8th.

I had my first fill Dec 26th (3 weeks post op) into my "bad" issued breast with 55cc and I felt completely fine. No Tylenol even. You should be fine but I did also read that some people find it painful but you would know right away and if you feel pain just ask dr to stop right away. I didn't have "pain" but sure just some tightening for a day or so, Advil definitely took care of it.

Good luck!

30 y.o. BRCA1+ strong family history; Nov '11 - PBMX w Implant Alloderm Recon.; Dec '11 - Implants out-TE in due to necrosis/infections; July'12 - Exchange
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Jan 2, 2012 06:59PM DocBabs wrote:

My fills started about 6-7 weeks after my BMX , 60ccs.From all that I read here I expected to feel "something" but actually felt little. The next day I had some minor spasms and took a Valium. Next fill of 60ccs I took a valium before and was fine. I refused my last fill. So I had 300ccs in OR and 120ccs afterwards for 420ccs. Exchanged for 457ccs. It's really not a bad process. You could ask for a smaller amount  each time.

DocBabs Dx 4/28/2011, IDC, Stage IA, Grade 1, 0/1 nodes, ER+/PR+, HER2- Surgery 5/12/2011 Lymph node removal: Right; Mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 5/12/2011 Lymph node removal: Right, Sentinel; Mastectomy: Left, Right Hormonal Therapy 7/14/2011 Aromasin (exemestane)
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Jan 5, 2012 01:16AM Azhelenmo1 wrote:

the time you get your fills are up to you and your doctors, I myself wanted them done and over and I was stubborn , I would get my fill on a Friday ,EVERY WEEK, about the 3 week I couldn't lift my arms over the week end and then by Thursday I'd just start to feel better and would do it again. by week 7 my expanders were at my chin and I couldn't lift my arms but I did  it, then 7 weeks later came the exchange.. Don't push yourself any harder than YOU want, Its your body and do what you want, feel comfortable with what your doing, Don't rush if your not in a hurry you'll get to the same place in the road, wether its fast or slow.   GOOD LUCK

Dx 8/4/2005, DCIS, Stage I
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Jan 5, 2012 09:44AM HantaYo wrote:


Josie, different PS fill differently based on their overall plan and your individual skin issues.  The elastic properties of the tissues stretch better if a little bit of time but not too much time elapses between stretching, but this needs to be balanced with how thin the skin might be.  Thin or compromised skin needs more time.  That said, most of the time the PS can adjust the fill timing/amount per fill with your comfort tolerance.  After the first couple of fills I experienced decreased discomfort, although with each fill I did feel a tight/tense sensation over  for several days.  My PS recommended tylenol or ibuprofen if I felt I needed it which usually I did not.  It was impossible to sleep on them of course.  Now that was painful when I tried.  I asked for a muscle relaxant because of the tightness/tensness but was denied.  I guess while I felt discomfort and tightness I did not interpret it as acutely painful.  I was still able to go to work and have periods where other activitities distracted me from those sensations.  But everyone is different and it is what it is.  Talk to your Ps, I am confident he will work with you so that you can have a schedule of fills that will be acceptable.


Surgery 11/12/1990 Lumpectomy: Right Dx 3/26/2010, DCIS, <1cm, Grade 3, 0/17 nodes, ER+/PR+ Surgery 4/29/2010 Lymph node removal: Right, Sentinel; Mastectomy: Left, Right Surgery 9/29/2010 Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 6/21/2011 Reconstruction (left); Reconstruction (right) Surgery 3/5/2012 Reconstruction (left); Reconstruction (right) Surgery 12/13/2012 Reconstruction (left): Nipple reconstruction; Reconstruction (right): Nipple reconstruction
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Jan 6, 2012 10:06AM KorynH wrote:

I was told there is no rush especially since, like you, I was in chemo during it all and couldn't do the exchange until 8 weeks post chemo. Plus I was told you can end up with stretch marks needlessly by rushing things. I went very slow...maybe 40cc - 60cc each fill and only about once a month. You'll get spasms no matter what you do. I still have them and I am 3 years out! That has little to do with the fills themselves. Just know that the expanders are nothing like the implants and once you have the exchange you will look and feel a whole lot better. The expanders were hard and oddly shaped and kind of freakish to me...although implants are not a natural breast they are the next best thing if you had to get breast cancer and didn't do a flap procedure. Best of luck!

KorynH -age 44 at diagnosis (2008) , IDC 1.6cm , ILC 1.6cm ,Rt. mast. 10/08, 0/6 nodes,stage 2a, gr. 3, ER+/PR+, Her2NU+++, BRCA Neg.,TCH chemo 12/08 - Herceptin completed 12/09, T.E., silicone implant exchange July 2009
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Aug 11, 2012 06:33PM azhelen wrote:

Every woman is different , I had my fills done and finished in 8 weeks and 6 weeks after that I had my implant exchange. then 6-8 weeks later had my areola and nipple reconstruction.. Do what is and feels right for you , there is no right or wrong answer discuss with your PS what you want and think you need.

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Aug 13, 2012 03:22PM pnkldy wrote:

I had 300ccs at the time of surgery. I went back for 50ccs, then 100ccs, then another 100ccs. This was in a 5 week time span. The first two went very smoothly. I felt some tightness, some discomfort, but generally ok. The fourth one, different story. Instant constant pressure. I ended up going back and having 50ccs removed from the left breast because of the pain. I just went in today and got the 50ccs replaced. Seems to be much better this time.

Dx 11/2011, IDC, 2cm, Stage II, Grade 3, 0/4 nodes, ER-/PR-, HER2- Surgery 1/13/2012 Lymph node removal: Left, Sentinel Chemotherapy 1/26/2012 Cytoxan (cyclophosphamide), Ellence (epirubicin), Fluorouracil (5-fluorouracil, 5-FU, Adrucil), Taxotere (docetaxel) Surgery 6/27/2012 Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement
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Aug 13, 2012 04:51PM Blessings2011 wrote:

I realize this is an old thread, but I am seeing this question a lot lately, especially from newbies who get filled in the OR, then their PSs start addidtional fills within days of MX, and keep going every week. This just makes no sense to me.

I got 180 ccs in the OR, then I got to wait a month for regular fills. I was filled to 620ccs within five visits, spaced two weeks apart. Then I had to wait an additional 3 months for exchange.

I had no pain with my fills, HOWEVER, I was overweight, had tons of loose skin, and very lax pectoral muscles. It was the only time in my life when being out of shape was of any benefit to me.

Ladies who are slender, have thin skin, radiated skin, any healing issues, or very tight pectoral muscles should adopt the motto "LOW AND SLOW"!" It's one thing to be able to stand big, rapid fills with no pain, but that's not what I'm hearing on the forum.

YOU control the amount and the timing of your fills. The PS can even remove saline if a particular fill is too painful. You can grit your teeth and take pain meds, or you can slow down and get smaller amounts put in, with more time in between to recover. It's not a race.

I actually chose to postpone exchange. I decided to lose weight before I got my permanent implants. Now that I'm back to normal weight, I can get the implant size that is appropriate for my body. I've had these TEs in since last December, and believe me, I'm ready for squishies! Nine days to go!!! WooHOO!

Dx 9/15/2011, IDC, <1cm, Stage IA, Grade 2, 0/3 nodes, ER+/PR+, HER2- Surgery 12/5/2011 Lymph node removal: Left; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 8/22/2012 Reconstruction (left); Reconstruction (right) Hormonal Therapy 9/5/2012 Arimidex (anastrozole) Hormonal Therapy 10/22/2013 Femara (letrozole)
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Aug 15, 2012 07:45AM BuddhaWolf wrote:

Blessings - WOOHOO INDEED!!! Oh Im so excited to hear your soon to be coming squishies! I fancy a pair myself but must wait...

I echo what you've posted - LOW & SLOW. I have tight pec's; My PS likes to fill 100cc each time / a month. I had 300cc at time of surgery. first fill I made it to 70cc. It felt tight & slightly painful (I took pain killers before). However, the following day I had pain radiating to my back - and was glad I didnt tolerate the full 100cc!

Also, advice offered to me by DawnHope was that large fills can cause stretchmarks - to many women- including me  a BAD word. So I am filling slowly and daily gently massaging oil into my breast to keep stretchmarks at bay. 

*Buddhawolf Dx:Feb 2010 6mm tumour/IDC -Grade 2. DCIS, papillary pattern-Intermediate grade.Triple negative. April 26 2010 - skin-sparing UNI MX/senitel node sampling (3:0) Revision Surgery May 2012, TE; recon ongoing
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Aug 15, 2012 09:51AM Leah_S wrote:

Buddhawolf, what kind of oil are you using when you massage? I'm getting my TEs soon so I'd like to know.



Dx 11/3/2008, IDC, 1cm, Stage IV, Grade 3, 6/17 nodes, ER+/PR+, HER2-
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Aug 15, 2012 12:24PM jill47 wrote:

Leah:  I just started using Coconut Oil as recommended by my PS many weeks ago. Been using coco butter lotion but didn't cut it. The coconut oil is wonderful and wish I started it weeks ago.  Using Barlean's Extra Virgin CO, it's USDA organic and bought it at Sprouts for $34. I imagine a local health food store in your country would carry it, you can also buy it on line. Note it can be used for cooking, hair, skin & body care. I wish you the best in your surgery and recovery.

5/2012 Grade 2 DCIS, 2+cm extensive comedo necrosis. 0/4 nodes. 98% ER+/99% PR+. LCIS/ALH presented after NSBMX 7/12. TH/BSO 8/13. Dx LE arm/truncal 10/2015. Convert to prepectoral 6/20/16
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Aug 15, 2012 04:46PM Leah_S wrote:

Thanks, Jill. I have coconut oil so I guess I'm prepared!


Dx 11/3/2008, IDC, 1cm, Stage IV, Grade 3, 6/17 nodes, ER+/PR+, HER2-

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