How to Sleep Comfortably After Breast Reconstruction with Tissue Expanders

In In The News by Barbara Jacoby

By: Jenna Fletcher


Surgeons perform breast reconstruction surgery with tissue expanders to help make room for permanent breast implants.

You may find that, following the procedure, you have trouble getting enough quality sleep. Discomfort, anxiety, and inability to sleep in a comfortable position can all affect the quality of your sleep.

Taking steps to manage discomfort, find comfortable positions, and improve your overall sleep hygiene may help.

What to expect during and after tissue expander surgery

Tissue expander surgery often occurs during a mastectomy. Surgeons place empty implants either above or below your chest muscles. They then use the expanders to make room for breast implants.

To do this, they’ll fill the expanders with air or liquid slowly over the course of about 6 to 8 weeks. Once you reach the agreed upon size, the surgeon will remove the expanders and replace them with permanent breast implants.

Sometimes, you may first undergo radiation treatment before surgeons replace the expanders with permanent implants, which requires several months of treatment and healing before the second surgery.

Your hospital stay following the implant of expanders will likely be less than 24 hours, which means you may be able to go home the same day as your procedure. Once home, you’ll want to follow all instructions from your healthcare team regarding caring for your incisions, returning to activities, and going to follow-up appointments.

Managing pain and discomfort

Having tissue expanders implanted following a mastectomy can be overwhelming. You may be worried about the level of pain and discomfort the expanders will cause, especially during sleep. But some research suggests that anxiety leading up to the procedure can be more intense than the physical pain you’ll experience.

In a 2017 study, researchers found that the procedure and process of expanding the tissue itself is generally not extremely painful. Instead, many people say it causes mild discomfort. But they found anxiety leading up to the procedure is often very high, likely due to the anticipation of being in a lot of pain.

They also found that most people only need ibuprofen or no medication at all to deal with discomfort or pain from the expanders.

If you find that you’re in a lot of pain, you may want to speak with your doctor about your concerns. They may be able to provide recommendations for added pain relief or, in some cases, provide you with stronger pain relievers.

After each expansion, you may also feel tightness or soreness in your chest that expands to your shoulders or back. To help with this, the following steps can help:

  • Take a warm shower.
  • Perform gentle exercises to help stretch and strengthen your chest as directed by your nurse or a physical therapist.
  • Use moisturizers to help the skin stretch.
  • Wear soft, supportive bras.

Best sleeping positions after surgery

Surgeons generally recommend that you sleep on your back following reconstruction surgery with tissue expanders. This helps keep pressure off your incisions and expanders.

If you typically sleep on your side or stomach, you may find this challenging. Here are some tips to help make it easier:

  • Try tucking a pillow under your knees.
  • Place an additional pillow under your head.
  • Practice sleeping on your back prior to the surgery to help train yourself to be ready.
  • Sleep in a recliner if possible.

After a few weeks, you’ll likely be able to transition to sleeping on both your back and side. But first, speak with your doctor about the timeline of when you can start to transition to other sleeping positions.

Additional tips for better sleep

Adjusting your sleeping position may make it more challenging to get some shut-eye, but there are several things you can do to make sleeping more comfortable.

Try the following steps to improve your sleep hygiene:

  • Go to bed at the same time each night.
  • Practice light exercises and stretches approved by your doctor regularly throughout the day.
  • Avoid large, heavy meals a few hours before bed.
  • Limit noise and light in your bedroom and before sleep.
  • Turn off electronic devices 30 minutes before bed.
  • Try to set your bedtime early enough to get between 7 and 8 hours of sleep.
  • Avoid caffeine, alcohol, or excessive liquids before bedtime.
  • Try to establish a relaxing bedtime routine.

If you have trouble falling asleep after 20 minutes, get out of bed and do a quiet, low-light activity for a few minutes until you feel sleepy. These tips can help create a relaxing environment that allows you to fall asleep more easily at night. But if pain is keeping you awake at night, consider talking with your doctor.

The takeaway

Sleeping after breast reconstruction with tissue expanders may be more challenging. You may experience discomfort and will have to sleep on your back or in a reclining position, which can be tough if you’re usually a side sleeper. Fortunately, many people report only mild discomfort, but if it persists, pain relievers may help.

You can also take steps to improve your sleep hygiene. This can include going to sleep at the same time each night, creating a relaxing environment, and avoiding electronic devices before bedtime.