The Story of the Unfulfilled Tissue Expander

Immediately following my mastectomy a tissue expander was put into my chest cavity where my murderous breast had lived. The plan was to heal from surgery, have radiation, heal from radiation and then start the process of expanding the area in preparation for an implant. Simple, right?

So with expander in place and sufficient time spent healing from the surgery I met with my radiation oncologist. At first he said that my expander needed to be filled before they could start radiation. So, my plastic surgeon was contacted and I went and had some saline pumped into my fledgling  expander:

           * There is a metal disc in the expander where the fill valve is. The doctor finds this by          dangling a magnet on a chain over the chest and wherever it attaches is where he pumps in the saline. I found this fascinating! I never tried this, but I often wanted to attach a note saying "Under Construction" to my chest with one of my refrigerator magnets. 

With as much saline injected into the expander as my skin would allow, (it ALMOST looked something like a breast) I went back to get the radiation ball rolling. After determining that there was a miscommunication somewhere (I'll take the blame because no one else is!) along the line I was told that there was too much saline in the expander and some would need to be removed....seriously!? So back to the Plastic Surgeon to have some of it sucked out!

Finally radiation could begin. Radiation IS NO FUN. but I'll address that in another post. I received 30 rounds of radiation and when I was done, I needed to heal for several weeks before I could begin to focus on reconstruction. Healing was slow and unpleasant but eventually my skin was healed enough to resume expansion.

I went for one expansion. 300 cc's of saline. It was beginning to look like a breast mound again. 3 weeks later I went for another fill up. Break out the trusty magnet to find the valve...the magnet is actually moving away from my body, kind of repelling my body...that's weird...try another magnet...repelling again. Huh! After lots of pushing and prodding, it is determined that my expander
has flipped over. Oh, sure, that probably happened when I was doing gymnastics (that's sarcasm for
anyone who doesn't know me well, I sit on the couch...especially at that point in my life)!

I would need to have a small surgery to flip my expander over. Oh joy! This would just be a quick surgery at a surgical center, not the hospital. I would just have a local and be awake for it, feeling nothing but hearing everything. Yick! I'll spare you the details but, I'll tell you, I've done more fun things in my life than that. Time to heal again and after several weeks I was ready to be expanded again. At my next appointment with my PS (Plastic Surgeon) he began filling, 100 cc's..."How does that feel?", "I don't know, I can't feel anything....haven't been able to feel anything in that area since my mastectomy." Another 100 cc's, "Doing ok?" "Sure? I can't feel anything." Third syringe, 100 cc's more....I'm not watching, because even though it doesn't hurt, I get a little wiggly in the stomach
watching the needle go into me. All of a sudden, "Sploosh!" And I hear liquid hit the floor. "What was that?" I asked. "The expander has been exposed." Said PS.

What the heck does that mean? Has my skin gotten too thin because of all the expanding, can you see through it now? What does that mean!? So, what really happened is that the incision sight split open and now I have a big hole in my chest in which you can actually see the expander. PS says that I am no longer a candidate for an implant. We will, instead, need to do a DIEP flap transplant and it will need to happen ASAP.

          *DIEP flap surgery is where they take skin, fat, nerves and blood vessels from your lower
abdomen and actually make a breast out of it. It is a big surgery. At least 8-10 hours and it involves microsurgery to attach the blood vessels and nerves. The bonus is, not only do you get a new breast, but you also get a tummy tuck. The down side is you could die, it could fail, your body could reject
it...

This surgery had to be scheduled right away. PS said it would be happening within the next few days. Major panic was going on in my head! I was sent home with an open hole in my chest and a piece of gauze shoved into my bra to cover it. They would be in touch with me very soon.  The next day when I woke up I was drenched in some kind of fluid. It wasn't blood but my chest was soaked and my expander was hanging out of my new chest pocket. I called PS to explain what was happening and to get advice on how to manage this, he wanted to see me the next day. OK. Next day: when I woke up I had a horrible pain in my chest, I was dizzy and nauseous. I had a terrible head ache and a fever. I had chills and I ached all over. I was quite certain that I would die that day. And, at that point, that was ok with me.

When we got to the PS the expander was almost completely out of my chest. PS pulled it out the rest of the way along with some of the most disgusting funk I've ever seen. I was septic. I could not have the DIEP flap surgery right now. The infection needed to treated and healed. But, in the mean time, I would need to have yet another surgery to clean out the pocket and close up the hole.

Surgery, antibiotics, healing...healing...healing. Then it was time for my 6 month check up with all of my doctors and that's when I found out that my cancer had spread and I was now stage IV.

There will be no reconstruction.