In breast reconstruction after a mastectomy, tissue expanders — temporary, fillable devices — are used to gradually create space in the breasts and stretch the skin. Your doctor fills them with gas or liquid — typically air or saline (sterile saltwater) — to help prepare the chest tissue for implants after a mastectomy. Reconstruction surgery is meant to rebuild the shape of the breast using plastic surgery techniques.

Many people complete the filling process over several weeks, but the exchange procedure may happen later — sometimes weeks or months after expansion is complete, especially if chemotherapy or radiation therapy is needed first.

Some members of MyBCTeam wonder what to expect from expanders, including how they feel.

“How does it feel to have tissue expanders in?” asked a member of MyBCTeam.

Another member replied, “It feels like you’re wearing an underwire bra that’s two sizes too small, 24/7.”

Expanders may be uncomfortable, but they’re a temporary step on the path to final breast reconstruction.

If you have tissue expanders, you may be eagerly counting down the time until the placement of permanent breast implants. Here’s what you should know about sizing goals and the differences to expect once the exchange happens.

How Big Do Expanders Need To Get?

Expanders play an important role in the success of breast reconstruction in many people. Most people should plan to have expanders for six to eight weeks before the exchange procedure, or longer if chemo and radiation therapy are needed first.

Expansion goals vary from person to person. Your doctor can advise you on the right pacing for expansion based on your unique situation.

Your surgeon will recommend the size and amount of expansion that is safest and most appropriate for your body. They also should be able to give you an idea of what to expect from the expansion process as you plan the second stage of breast reconstruction.

Communicating with your healthcare providers throughout the process is essential so you feel comfortable and satisfied with your final results.

Choosing the Right Size for Implants

Expanders give you a chance to take a step back and think about your options for reconstruction. While you may have a specific cup size in mind before your mastectomy, people sometimes change their minds after the procedure or while the expanders are in.

It’s OK to talk to your plastic surgeon about going bigger or smaller before deciding on implants. Expanders allow you to weigh your options and think about what different implants will feel like when you make your final decision.

Larger implants can sometimes come with a higher risk of problems because they may put more pressure and stretch on healing tissue. But risk isn’t based on cup size alone. Factors that may matter more include:

• Your body size
• Your overall health
• Whether you smoke or have diabetes
• How well your skin and tissue heal

If you’re interested in larger implants, your surgeon can help assess your risk for complications based on several factors, including your age, weight, lifestyle habits, and general health.

How Do Implants Feel Different Than Expanders?

Most MyBCTeam members report feeling relieved after the exchange surgery, when implants are put in place of the expanders.

“Good news: The implants are comfortable,” one member shared.

Another shared, “The expanders felt pretty uncomfortable for the 10 months that I had them. … When I had them exchanged for implants, 98 percent of the discomfort went away. Most of the time, I hardly even notice them, which is a total contrast to expanders. I was aware of those suckers 100 percent of the time.”

It’s important to be realistic about your implant expectations. Although implants have a generally high satisfaction rate, revisions or lingering issues can sometimes happen. Be sure to continue sharing your progress with your healthcare team and relaying any concerns about pain or discomfort.

If you’re concerned about your expanders or unhappy with your implants or the results of your reconstruction surgery, there may be additional steps you can take to improve the outcome.

Join the Conversation

On MyBCTeam, people share their experiences with breast cancer, get advice, and find support from others who understand.

Did you have tissue expansion before implant placement? How was your experience with expanders and reconstruction procedures? Let others know in the comments below.