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Topic: Question about uneven tissue expanders

Forum: Breast Reconstruction —

If you've had or will be having a mastectomy (or in some cases, lumpectomy), you're likely facing decisions about whether or not to have breast reconstruction, and if so, what type and when. Deciding whether or not to have a breast reconstructed is a very personal choice. Take the time you need to learn about how breast reconstruction might affect you, both emotionally and physically, before you decide to have the surgery.

Learn about different surgical options and the medical and personal issues around breast reconstruction.

Intro medically reviewed by: Brian Wojciechowski, M.D.
Last review date: November 22, 2020

Posted on: Jan 18, 2021 07:11PM - edited Jan 18, 2021 10:06PM by Jocelyneyesenia1

Jocelyneyesenia1 wrote:

Hi everyone!

I underwent a prophylactic nipple sparing bilateral mastectomy with immediate expander reconstruction. I also had lymph nodes removed from the left side.

I have had two fills since then and I have noticed that the left breast (side they took lymph nodes from) is sitting higher on my chest than the right one. I can also see the tabs of the expander. The breasts have a different shape and my nipples are not leveled.

I was wondering if anyone had this experience and once the exchange happened ended up with a symmetrical result. Or if what my breasts look like now will be more or less what they look like with the implants.


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Jan 18, 2021 10:01PM MinusTwo wrote:

Jocelyn - use the search option & look for Exchange.

Personally from what I've read, I think it's very hard to make nipples match - but experienced plastic surgeons can work miracles. Ask your doc.

2/15/11 BMX-DCIS 2SNB clear-TEs; 9/15/11-410gummies; 3/20/13 recurrance-5.5cm,mets to lymphs, Stage IIIB IDC ER/PRneg,HER2+; TCH/Perjeta/Neulasta x6; ALND 9/24/13 1/18 nodes 4.5cm; AC chemo 10/30/13 x3; herceptin again; Rads Feb2014
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Jan 26, 2021 12:26AM Lille wrote:

Hi Jocelyn. You are by far not the only one to experience uneven tissue expanders. I had a bilateral mastectomy in July and my right sat higher than the left, it was also displaced somewhat laterally. The good news is that my PS brought them closer together and did some fat grafting that makes the inner curves look nice. He also brought the right one inwards and down further however it is still at least a centimeter higher. It might be harder to notice if it wasn't for the disparity in where the nipples sit. Granted I am only going on two months out and things can still shift. It is perhaps the most disappointing thing in the end, that daily reminder. In essence, yes it can affect permanent placement but they can close the gap. If my right pocket could just drop one centimeter it would make all the difference, sooo close

Dx 6/5/2020, DCIS, Right, Stage 0, Grade 3, 0/5 nodes, ER-/PR- Surgery 7/13/2020 Mastectomy: Right; Prophylactic mastectomy: Left; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Surgery 12/2/2020 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant
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Jan 28, 2021 12:34AM OnTarget wrote:

My TEs were even, but my implants were 1/2 inch off and it drove me nuts.

One got infected, so we started over with a TE.

I'm psycho, so I used a level to perfectly sunburn sports bra lines into my chest so the doc had a level point of reference.

My TEs are perfect and I'll do it again when I finally get my new implant. I hope they end up even!

I think you doc can adjust things during surgery.

Diagnosed at 42, Oncotype score 16, ITC in one node- considered node negative. Lost right implant to infection March 2020. Waiting to start reconstruction all over again. Dx 4/8/2019, ILC, Left, 3cm, Stage IB, Grade 2, 0/3 nodes, ER+/PR+, HER2- Dx 4/23/2019, ILC, Right, <1cm, Stage IA, Grade 2, 0/2 nodes, ER+/PR+, HER2- Surgery 5/15/2019 Lymph node removal: Sentinel; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Hormonal Therapy 6/14/2019 Zoladex (goserelin) Chemotherapy 8/6/2019 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Surgery 11/6/2019 Reconstruction (left): Silicone implant; Reconstruction (right): Silicone implant
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Apr 7, 2021 12:54PM fairy21 wrote:

I’m in the same boat! I had a nipple sparing double mastectomy in March 2021 with tissue expanders and just had second fill. I’m uneven and my nipples are pointing in different directions. It was so devastating to loose my breasts and I still feel so hacked up. :( Now I’m terrified I will be uneven with bizarro nipples. They have told me I will look completely different a year from now and to avoid thinking “this is it” but it’s so hard!!!!

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