My Bilateral Mastectomy with Tissue Expanders

Nine weeks doesn’t seem like a long time, but that’s how long it was for me (by choice) between my breast cancer diagnosis and surgery. Nine weeks also isn’t very long at all when its the last bit of time with your boobs. Right now I am three days post op, and I am feeling good enough to share how my “Bilateral Mastectomy with Tissue Expanders and Right Lymph Node Biopsy” went.

Warning – there are graphic photographs ahead. If you do not want to see my boobs, or post op pics, this is not the post for you!

My surgery was scheduled for the evening so I didn’t have to get to the hospital until 4pm.  This was similar to my lumpectomy, when I had to arrive at 5pm. I was therefore expecting a similar wait of around three hours before I went to surgery.

It didn’t happen like that though. I was taken to my room at about 4:15, and before I could really settle in, a nurse came in to go through all the details on my admission forms. Before she had even finished the breast care nurse came in to introduce herself and give me some information. She had barely started talking and the orderly was knocking on my door saying I was required in the holding area as the surgeon was almost ready for me!

I quickly got changed into my delightful surgical wear and by 4:45pm was being wheeled to the operating theatres. I ended up then waiting in the holding bay until 6pm, meeting with both the surgeon and the anaesthetist. I was really surprised at how calm I was feeling. I had expected to be freaking out at about this stage, but I was more eager to just get it over with than worried about it.  

My surgery went for about two hours. I came out of the anaesthetist feeling pretty good. It took a couple of minutes to fully wake up, but I had no nausea and I was again eager to go straight back to my room. By 9pm I was comfortably tucked up in my room. I was not in any pain at all which was fantastic. It was actually hard to believe that I had just had my boobs removed! 

After the mastectomy part of the surgery, expanders were inserted under my pectoral muscles. This is the part that causes most of the pain with this procedure. Over time these expanders are filled with saline to create a new pocket against the chest wall. Eventually there is a second surgery to swap the expanders for implants.

This is about two hours post op. The red is disinfectant they smear everywhere, and the black is the textra they use

That first evening was a constant stream of checks by the nurses. I had one-hourly obs for much of the night, and felt like I was constantly being given one drug or another. I was taking painkillers (only paracetamol), anti inflammatories, and anti constipation tablets (since the other tablets cause constipation lol) and having intravenous antibiotics every few hours as well. I was allowed up to the bathroom with supervision at about midnight, and after that I was free to get up by myself.

I had four drains, two from each side from just under the edge of each boob. The tubes are about two metres long and attach to a bulb that is slowly sucking out any fluid that is building up during the healing process. These have really been the worst part about this whole process, as I have to carry them around with me everywhere! The only pain I have is if I pull on them or catch them on something as I move.

Rocking the hospital garb and carrying my drain bags, about 24 hours post op
Rocking the hospital garb and carrying my drain bags, about 24 hours post op

During the surgery my expanders were partially filled, so I have not ended up flat chested. I am actually pleasantly surprised at just how much shape I have. I know there is a lot of swelling still at the moment, but it’s nice, psychologically, to not be completely flat.

Many people opt not to be reconstructed after their mastectomy – for lots of different reasons. I immediately wanted to be reconstructed, I think so that I could more easily feel like I was getting back to normal after all of this. But there was a time a few weeks ago where I considered going flat. The idea of it doesn’t entirely freak me out, and if at some time in the future I have to resort to that, then it will be fine, but I think the shape now has definitely helped to ease the shock.

I have absolutely no feeling in my chest. All of the nerves were severed when the breast tissue was removed. It’s actually a very bizarre sensation to know I am touching my own skin but I can’t feel a thing. The expanders are also quite hard,  kind of like how hard they get when breastfeeding and it’s been a few hours since a feed. The implants will be a lot softer.

At 36 hours post op. I've been able to clean off most of the disinfectant and texta, but no shower yet. There is a lot less swelling already

All in all it has been a much easier procedure than I expected. The hardest parts are dealing with the drains and lack of sleep from being in hospital. On day two, two of the drains were removed, and at this stage it is likely I will have the last two out tomorrow (day four) and get to go home. Many surgeons send their patients home with the drains in, but mine prefers the drains to come out before leaving hospital. And if it comes to it, I would rather one extra day in here than going home and dealing with the drains at home for a week before I can get in to see him again to get them removed.

Oh, and the rumours are true – hospital food is terrible! And where I am they pretty much have no vegetarian options. I’m having a salad sandwich for lunch for the third day in a row today!

Any questions? I am happy to answer anything you want to know. Just ask in the comments below and I will get back to you.


  1. Sally says:

    I am amazed at how “unflat” you are – so happy your pain is manageable.

    Will you be able to wear a bra? Or is that a few weeks away when the swelling settles?

    You mentioned expanders and for some reason I thought little metal things – sort of plastic versions of the little ‘table’ thing they put in takeaway pizza boxes to stop the box lid from touching the pizza toppings. I am now thinking like a plastic bag?

    1. Josie Kelsh says:

      Hi Sally

      Yes, the expanders are like an empty implant, but a lot more heavy duty in terms of the casing. They also have a valve on them that is used when in a few weeks saline is added via syringe. They have been partially filled already which is what is giving me the shape. My surgeon said this would be the case, but he didn’t know how much he could fill until he was doing it, and I had in my mind it would only be little and I would be fairly flat.

      I am already wearing a bra – in fact it was given to me right ofter the second photo was taken – it’s an ugly surgical bra, so soft, kinda like a sports bra or crop top. This is meant to help keep the expanders in the right place so I have to have it on day and night. I’ve heard that different surgeons do different things with the bras though.

  2. Lesa says:

    You have been very fortunate in your recovery. What amazes me is your DMX was only a 2 hour surgery. My surgery was almost 9 hours. I’m trying to put the pieces together. My reconstruction has been a disaster. Thank you for your blog.

    1. Josie Kelsh says:

      Thanks Lesa. I know! I was shocked when my surgeon said it would only be 2-3 hours. All my reading before hand said 3-4 hours per side. But that’s what it was, and the results are good, so I can’t complain.

      Good luck with getting your reconstruction sorted, I hope it comes together in the end.

  3. ginette says:

    I am only just beginning my journey, I have so many questions. Your reconstruction looks amazing, I will hope mine wind up half as nice.
    I’m much older than you, 66 is right around the corner and I’m not sure how much support my husband will be, in the end. 46 years and I think I knew him better then than I may today.

    1. Josie Kelsh says:

      Urgh, men! They are more scared than we are half the time. It’s not an excuse, but boy they can be useless when we need them sometimes! Good luck with your treatment. I’m always willing to answer questions if I can.

  4. Dawn says:

    When they do the expander to implant surgery do they go underneath the breast with another incision or do they go through the existing incision from the cancer surgery? My left incision was nice and straight my right one has a big curve in it and it’s really ugly looking, so if they go in through the old incision I am hoping they can straighten out the line a little bit?

    1. Josie Kelsh says:

      Hi Dawn. For me they used the same incision – but only the outside half of it, towards my armpits. I have heard that some surgeons choose instead to use the crease underneath, but I assume that you get to have a say in that. I would suggest discussing with your surgeon and letting them know you want your scar fixed too and see what they say. Good luck!

  5. Stefanie says:

    I am thankful to have come across your blog. It has been very helpful. I have my double mastectomy this Friday. I too will have 4 drains but have been told they will be in for up to 3 weeks. That is wonderful that yours were able to come out to quickly. How was your doctor able to make this happen for you? I was told my expanders will be filled with air halfway and then later the air will be removed and filled with saline.

    1. Josie Kelsh says:

      Hi Stefanie. I think a lot of it was just luck! It possibly helped that here in Australia we are able to stay in hospital for longer so get almost complete rest. I don’t know exactly if this is a factor, as there are some people here who still have drains for longer. Good luck with how it all goes.

Leave a Reply

Your email address will not be published. Required fields are marked *