Table of ContentsView AllTable of ContentsSources of PainSelf-Care StrategiesMedicationsPhysical TherapyWhen to Call a Healthcare ProviderFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Sources of Pain
Self-Care Strategies
Medications
Physical Therapy
When to Call a Healthcare Provider
Frequently Asked Questions
Tissue expandersare temporary, expandable, balloon-like devices used after amastectomyto stretch breast skin and chest wall muscles. This is done in advance of breast implants so that the chest wall and skin can accommodate them.
Because of the stretching involved, tissue expanders can be painful or uncomfortable. However, there are a variety of ways to deal with the discomfort as you begin the process of breast reconstruction.
Read on to find out more about the process of using tissue expanders, things you can do at home to relieve the pain, medications to help, and physical therapy.
Verywell / Brianna Gilmartin
Why Tissue Expanders Cause Pain
A tissue expander is usually put in duringmastectomy surgery. The expander is inserted underneath the chest muscle. The device is a small pouch that will be expanded gradually over a period of weeks or months with saline injections through a fill port.
A tissue expander should not cause changes in the color of the breast tissue. If it does, let your healthcare provider know. The device will likely need to be slightly deflated.
Pain tends to be worst in the first 12 to 24 hours after the expander is filled, and generally subsides after two to three days. If you have expanders on both sides, one side may feel more painful than the other.
Simple pain-relieving strategies may be effective in managing tissue expander pain. When those aren’t enough, medications or an adjustment of your expanders may be needed.
Additional Causes of Tissue Expander Pain
Verywell / Britney Willson
There are many things that you can do on your own to improve your comfort while you have your expander in place.
Some things to try:
Post-Mastectomy Bras: Types, Fit, and Cost Coverage
Your healthcare provider may recommend:
It’s extremely common for women to have chest and shoulder discomfort and stiffness after a mastectomy, and it can be difficult to know whether the pain is due to the expander or changes related to surgery and/or radiation.
Many women benefit fromcancer rehabilitation, especiallyphysical therapy, after a mastectomy.
A 2019 study in theJournal of Breast Cancerconcluded that early rehabilitation after mastectomy and tissue expander placement significantly improves shoulder mobility over the long term.
The best option is to see aphysical therapistwho is specifically trained in cancer rehabilitation and has experience working with women who have had breast cancer surgery.
Together, you can work out a plan that includes both in-office and at-home procedures and exercise to minimize pain and enhance mobility.
Tissue expander pain is typically limited to the first 24 hours following a fill.If your pain lasts longer than a day, it’s important to call your healthcare provider.
When it comes to tissue expander pain, it’s always best to err on the side of caution and call your healthcare provider if the pain is persistent, worsening, or causing you stress or loss of sleep. Pain may also be a sign of aninfection. Infections that are diagnosed early are easier to manage with local or oralantibiotics.
Your healthcare provider may opt to remove some of the saline from your expander so that your muscles won’t stretch too fast. Larger fills can increase the risk of skin breakdown and infection, especially if you are having radiation.
Signs of InfectionCall your healthcare provider immediately if you experience any signs of infection during tissue expansion, including:FeverChillsIncreased redness, swelling, pain, or tenderness in the breastA pus-like dischargeCrusting around the filling port
Signs of Infection
Call your healthcare provider immediately if you experience any signs of infection during tissue expansion, including:FeverChillsIncreased redness, swelling, pain, or tenderness in the breastA pus-like dischargeCrusting around the filling port
Call your healthcare provider immediately if you experience any signs of infection during tissue expansion, including:
Summary
If you opt for breast reconstruction post-mastectomy, tissue expanders are used to help prepare the chest wall and skin for the implants. They can be uncomfortable, but there are ways to manage the pain, including home remedies and medication. Physical therapy can also be effective in helping to enhance mobility. If your tissue expanders are very uncomfortable, if nothing is relieving the pain, or you have signs of infection, contact your healthcare provider.
Whatever method you use for pain relief, it’s important to take care of your skin. The skin above your expander is at risk for breakdown and infection if not cared for properly.
What to Expect With Nipple and Areola Reconstruction
Frequently Asked QuestionsYes. Sometimes after an expansion, you may feel some pain or discomfort in the shoulder or back. This usually goes away within a few days.After your tissue expander has been the correct size for about one to three months, you’ll have another surgery to replace the expanders with implants. The surgery lasts about one to two hours, and you’ll stay in the hospital afterward for anywhere from a few hours to 24 hours.For the first two weeks, you should sleep on your back or in a recliner chair to be more comfortable.After those two weeks, you can sleep on your side if you’d like. For the first four weeks, you should not sleep on your stomach.
Yes. Sometimes after an expansion, you may feel some pain or discomfort in the shoulder or back. This usually goes away within a few days.
After your tissue expander has been the correct size for about one to three months, you’ll have another surgery to replace the expanders with implants. The surgery lasts about one to two hours, and you’ll stay in the hospital afterward for anywhere from a few hours to 24 hours.
For the first two weeks, you should sleep on your back or in a recliner chair to be more comfortable.After those two weeks, you can sleep on your side if you’d like. For the first four weeks, you should not sleep on your stomach.
9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Bellini E, Pesce M, Santi P, Raposio E.Two-stage tissue-expander breast reconstruction: a focus on the surgical technique.Biomed Res Int. 2017;2017:1791546. doi:10.1155/2017/1791546Le NK, Garcia-Molina C, Kumar Al.Pain and anxiety levels of patients undergoing tissue expansion after mastectomies: a case series study.Cancer Control. 2017 Nov;24(4):1073274817729893. doi:10.1177/1073274817729893Straub JM, New J, Hamilton CD, Lominska C, Shnayder Y, Thomas SM.Radiation-induced fibrosis: mechanisms and implications for therapy.J Cancer Res Clin Oncol.2015 Nov;141(11):1985-94. doi:10.1007/s00432-015-1974-6Singh P, Chaturvedi A.Complementary and alternative medicine in cancer pain management: a systematic review.Indian J Palliat Care.2015 Jan-Apr;21(1):105-15. doi:10.4103/0973-1075.150202Strazisar B.How to relieve pain after immediate breast reconstruction with sub muscular tissue expander.J Anesth Clin Res.2016;7:665. doi:10.4172/2155-6148.1000665Kim KH, Yeo SM, Cheong IY.Early rehabilitation after total mastectomy and immediate reconstruction with tissue expander insertion in breast cancer patients: a retrospective case-control study.Journal of Breast Cancer.2019;22(3):472-483. doi:10.4048/jbc.2019.22.e40Memorial Sloan Kettering Cancer Center.Breast reconstruction using a tissue expander.UCLA Health.Implant reconstruction.The Breast Center.Sleeping with tissue expanders.
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Bellini E, Pesce M, Santi P, Raposio E.Two-stage tissue-expander breast reconstruction: a focus on the surgical technique.Biomed Res Int. 2017;2017:1791546. doi:10.1155/2017/1791546Le NK, Garcia-Molina C, Kumar Al.Pain and anxiety levels of patients undergoing tissue expansion after mastectomies: a case series study.Cancer Control. 2017 Nov;24(4):1073274817729893. doi:10.1177/1073274817729893Straub JM, New J, Hamilton CD, Lominska C, Shnayder Y, Thomas SM.Radiation-induced fibrosis: mechanisms and implications for therapy.J Cancer Res Clin Oncol.2015 Nov;141(11):1985-94. doi:10.1007/s00432-015-1974-6Singh P, Chaturvedi A.Complementary and alternative medicine in cancer pain management: a systematic review.Indian J Palliat Care.2015 Jan-Apr;21(1):105-15. doi:10.4103/0973-1075.150202Strazisar B.How to relieve pain after immediate breast reconstruction with sub muscular tissue expander.J Anesth Clin Res.2016;7:665. doi:10.4172/2155-6148.1000665Kim KH, Yeo SM, Cheong IY.Early rehabilitation after total mastectomy and immediate reconstruction with tissue expander insertion in breast cancer patients: a retrospective case-control study.Journal of Breast Cancer.2019;22(3):472-483. doi:10.4048/jbc.2019.22.e40Memorial Sloan Kettering Cancer Center.Breast reconstruction using a tissue expander.UCLA Health.Implant reconstruction.The Breast Center.Sleeping with tissue expanders.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Bellini E, Pesce M, Santi P, Raposio E.Two-stage tissue-expander breast reconstruction: a focus on the surgical technique.Biomed Res Int. 2017;2017:1791546. doi:10.1155/2017/1791546Le NK, Garcia-Molina C, Kumar Al.Pain and anxiety levels of patients undergoing tissue expansion after mastectomies: a case series study.Cancer Control. 2017 Nov;24(4):1073274817729893. doi:10.1177/1073274817729893Straub JM, New J, Hamilton CD, Lominska C, Shnayder Y, Thomas SM.Radiation-induced fibrosis: mechanisms and implications for therapy.J Cancer Res Clin Oncol.2015 Nov;141(11):1985-94. doi:10.1007/s00432-015-1974-6Singh P, Chaturvedi A.Complementary and alternative medicine in cancer pain management: a systematic review.Indian J Palliat Care.2015 Jan-Apr;21(1):105-15. doi:10.4103/0973-1075.150202Strazisar B.How to relieve pain after immediate breast reconstruction with sub muscular tissue expander.J Anesth Clin Res.2016;7:665. doi:10.4172/2155-6148.1000665Kim KH, Yeo SM, Cheong IY.Early rehabilitation after total mastectomy and immediate reconstruction with tissue expander insertion in breast cancer patients: a retrospective case-control study.Journal of Breast Cancer.2019;22(3):472-483. doi:10.4048/jbc.2019.22.e40Memorial Sloan Kettering Cancer Center.Breast reconstruction using a tissue expander.UCLA Health.Implant reconstruction.The Breast Center.Sleeping with tissue expanders.
Bellini E, Pesce M, Santi P, Raposio E.Two-stage tissue-expander breast reconstruction: a focus on the surgical technique.Biomed Res Int. 2017;2017:1791546. doi:10.1155/2017/1791546
Le NK, Garcia-Molina C, Kumar Al.Pain and anxiety levels of patients undergoing tissue expansion after mastectomies: a case series study.Cancer Control. 2017 Nov;24(4):1073274817729893. doi:10.1177/1073274817729893
Straub JM, New J, Hamilton CD, Lominska C, Shnayder Y, Thomas SM.Radiation-induced fibrosis: mechanisms and implications for therapy.J Cancer Res Clin Oncol.2015 Nov;141(11):1985-94. doi:10.1007/s00432-015-1974-6
Singh P, Chaturvedi A.Complementary and alternative medicine in cancer pain management: a systematic review.Indian J Palliat Care.2015 Jan-Apr;21(1):105-15. doi:10.4103/0973-1075.150202
Strazisar B.How to relieve pain after immediate breast reconstruction with sub muscular tissue expander.J Anesth Clin Res.2016;7:665. doi:10.4172/2155-6148.1000665
Kim KH, Yeo SM, Cheong IY.Early rehabilitation after total mastectomy and immediate reconstruction with tissue expander insertion in breast cancer patients: a retrospective case-control study.Journal of Breast Cancer.2019;22(3):472-483. doi:10.4048/jbc.2019.22.e40
Memorial Sloan Kettering Cancer Center.Breast reconstruction using a tissue expander.
UCLA Health.Implant reconstruction.
The Breast Center.Sleeping with tissue expanders.
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