Reconstruction after RADIATION

BayouBabe

Hollyboo - I know some surgeons like to radiate with an expander in place. It helps keeping the skin from getting too tight. However, many women here have done it both ways. Did you have skin sparing? Please find a surgeon you like, and who you feel likes you. I also know that there are a few threads here about heavier women getting reconstruction as well. My heart is with you! Good luck!

kestrelgurl

mary,

I had the same tightness in my radiated side and it drove me crazy despite lots of stretching and exercise. And the TE's were just yucky! However, now that I have my implants, I notice that there is hardly any tightness. Nowhere near what there used to be. Guess the TE's stretched everything out or PS did a great job of releasing scar tissue.

No matter.....things are MUCH better!

peepgirl

I had bmx July 2012 (cancer in both breasts) and tissue expanders, chemo, radiation and exchange to implants 2 months ago in June.  All seemed to be going well until this past weekend when my left breast decided to start spitting out the implant.  That side had radiation to the breast and clavicle and apparently the skin just wasn't up to the task of containing the implant.  My PS told me all along that with radiated skin anything can happen.  So, tomorrow the left implant will come out and I will be facing a LD on that side sometime down the road.  Just keeping my fingers crossed that the right implant remains successful.

BayouBabe

Peepgirl - I am so sorry you are going through this! BC and rads sure suck, don't they?



Now you have me worried. How was your skin prior to implants? Did your PS use any alloderm or do fat grafting to help with the radiated skin issues?



Sending you hugs as you heal and mourn the loss!

Walkinginfaith

I had BMX with TE. Will have rads after fully filled then implants once the skin has healed. Anyone have experience with that?

BayouBabe

Walkinginfaith - that is exactly how I had mine done. The hard part was the rapid expansion so I could get into rads ASAP. Sounds like most women have a much easier time with slow, small fills. I had about 100ccs each time. Ouch. I am just over two weeks out from exchange. I had fat grafting at same time. Alloderm was used at time of BMX. (Both of these are supposed to be beneficial for rads breasts, so check into them if you can.). So far I am happy with the results. Rads breast is tighter and higher, but in a bra they both look very good and symmetrical. Hard to get perfection with rads.



How soon before you start rads? How are fills going for you?

peepgirl

BayouBabe,

It sure does suck.  I thought I was essentially "done" and now feel like I am starting the reconstruction process over.  So it goes.

To answer your question, my skin took a beating by the end of rads but at the time I had the implants it had healed well and looked good.  The PS used alloderm and skin grafting at the time of the exchange to implants.

The exchange from tissue expanders to implants was an "easy" surgery so I do not regret trying to make a go of it without the LD, which is much more invasive.  If one out of the two works out I guess I will count myself lucky.

Time to move on and face the next hurdle.  I'm just grateful I have another option to pursue.

Good luck to you!

BayouBabe

Peepgirl - I sure wish doctors would figure this whole thing out so there wouldn't be so many hurdles to face. Wishing you well for your procedure tomorrow, and have my fingers crossed with you for continued success for the right. Let me know how you do. My heart is aching for you right now.

Walkinginfaith

Bayou - my PS didn't want to use alloderm as I had surgery four weeks after chemo and he was afraid of my immune system not being back to normal and thought increased chance of complications. Did you use any lotions during rads to keep your skin intact? First fill was 60cc. Next one is next week.

BayouBabe

Walkinginfaith - I used Lubriderm for sensitive skin, alternated with 100% aloe. I would even bring aloe into the rads dressing room to use before I left. I also did not wear a bra during this time to prevent irritation ( I lived in large men's Hanes Tshirts when I was home.). I also stayed extremely well hydrated, cool showers only to prevent drying out skin, and Dove for sensitive skin bar soap only. Check on the alloderm - some PS will use it at exchange surgery time as well or instead. Rads is tedious and tiring, but doable. Hope it all works out with skin intact for you!

Walkinginfaith

Bayou - did your RO recommend those lotions? Mine wants to start only with a powder and then lotion if there are skin breakdown issues. I would like to be proactive. I know a whole lot more now to make my case than my initial RO consult months ago.

christina0001

peepgirl, I am so sorry about your implant.  I can't imagine how frustrating that must be, after going through all that you already have.

I had a UMX + radiation last year, and just had a DIEP recon on 7/30 and so far it is going really well. The radiated skin initially turned bright red and has peeled quite a bit. My surgeon says that is totally normal. I am using 100% aloe and it is healing beautifully. A lot of ladies here seem to have used tissue expanders but I did not. They say the results are better but honestly I am extremely pleased with my results so far. The shape and contour of my new breast is similar to what the "original" was and I am hopeful that as time passes and the swelling goes down, it will be even better. peepgirl if you have the tummy fat to spare I would recommend a DIEP, although it has been a slow and hard recovery. 

BayouBabe

My RO did not recommend in particular, but said I could use those if I wanted. I used what a lot of the ladies here on the boards used. Worked for me!

peepgirl

Thanks for all the kind words, ladies.  I really appreciate them.  PS's office now says implant removal surgery will be on Thursday or Friday.  I'm okay with that.  Gives me time to get used to the idea.  I told my husband the only thing I'm hoping for now is if the right implant is going to go the way of the left, that it does so soon so I can keep the additional surgeries to a mininum:)  I keep reminding myself what the PS told me "It will take some time, but I can fix this."  Lots of worse things you can hear at the doctor's office, as we all know.

I continue to hope all goes well for you brave ladies.  I keep you in my thoughts and prayers.

Andrea623

Peepgirl, good luck with your surgery! That's so frustrating to have to begin again. I have to admit, I'm a little worried now. I had rads, which ended in December, and had my exchange to implants 6 weeks ago. My skin held up well to rads, with only problems for a few days after my last treatment. My skin was red, hurt and was extremely sensitive, but never blistered or broke open. I was nervous about implant reconstruction due to reading about the failure rates, but I didn't want to have flap reconstruction.



Walkinginfaith, my RO said to only use Miaderm, so that's what I did. When I was extra tender after rads, I started using calendula cream, which was recommended by several women on this board. My RO was okay with it. The calendula cream was a lot more soothing than the Miaderm and I think it helped me heal quickly. I bought mine from Dermstore.com, and it arrived very quickly. Here's the one I bought:



http://www.dermstore.com/product_Calendula+Cream_27831.htm

hollyboo

Bayou Babe and Andrea and all the rest,



Thanks for all the skin soothing tips I start radiation tomorrow and just ordered the calendula online. Have the aloe and lubraderm.



Don't know how much my skin will tighten. It is not flat but not a flap either. More like a shallow volcano crater with ridge around the crater except at top of where breast used to be.



It is a two hour RT drive so I will see tomorrow how I do w working,. Radiating and then working again. This is like another 1/2 time job just getting to radiation!



hollyboo

Andrea623

Good luck, hollyboo! I didn't have any problems working, except for a little fatigue. It's just tedious going for those appointments day after day. Bet you do great!

Andrea623

Peepgirl, did you notice any problems before your skin decided to reject the implant? I'm just wondering if there are any warning signs I should watch for.

peepgirl

Andrea, I was 2 months post surgery and to my untrained eye was pretty much healed up.  It started on Thursday with a small opening (about the size of a pinky nail).  I went to the PS and they thought it could be the skin "spitting" out a suture that hadn't dissolved as there was a suture knot in the opening.  It remained that way for a few days and then on Sunday it split open the whole length of the the suture line.  I was amazed that could happen 2 months post surgery but the PS said they've seen it happen as far as 6 months out, unfortunately.

I will say that my left side was the hardest hit by BC.  It had the bigger tumor necessitating more scraping of the skin during surgery, as well as radiation to the clavicle and breast.  I'm thinking the combination of skin made thin by scraping and extra tight because of radiation in 2 quadrants is what caused the problem. 

Even if I had known at the time of my mastectomy that I needed radiation (which I didn't) I might have rolled the dice anyway and tried for this less invasive process of implants only for reconstruction.  I'm keeping my fingers crossed that one of the two will work (so far so good with the right breast which was also radiated).  And, again, while not looking forward to LD I am grateful that option exisits.  For me, personally, I am not ready to be without some kind of breasts so I will suck it up and deal with another surgery.  That's a personal choice each of us has to make.

You may be one of the lucky ones; I hope you are! 

Andrea623

Peepgirl, you've really been through a lot. I hope your LD reconstruction goes well, and that it's successful. Thank you for sharing your story with me. I hope I'm one of the lucky ones too. My incision on the rads side isn't healing as fast as the non-radiated side. It sometimes stings, like a wound feels when alcohol is poured on it. I saw my PS yesterday, but he didn't seem concerned, so I hope there's nothing to worry about. I'm keeping a close eye on it though.

I don't know where you'll be posting about your LD surgery, but I hope you'll update this thread, so I'll know how you're doing. Take care!

cledora

I had radiation treatments done to right breast. I was told I couldn't have implants because of this.  Then when I got cancer again, the plastic surgeon said we would do implants.  Well, the radiated side ended up making my expander rupture. I was told I really should'nt have had implants put in. I am now in the process of having fat grafting surgery in Sept 2013. This procedure is suppose to help softened the radiated side and fill in the breast.                            Cledora

patriciahurtado

Hello my ladies ... I lost this forum glad I fun it!!! Ok so I finished rads on 22 of August 2013 ... My last day of treatment my skin turned red and for the past 5 days skin was peeling under my armpit .... Now is healing.., saw my PS today and he said that is hard to tell until a month from here and to make sure to massage my chest do lots of stretching ..... Well i started with vitamin E on it. Some massages .... I don't feel that my chest is tight .... But I will be seen a new PS for second opinion .... Also I would like to have fat grafting before anything so will see how it goes .... Also I didn't want to do any hysterectomy so soon postponed it till October ...



Any advice on stretching ???

patriciahurtado

Cledora have you had your fat grafting? Please let us know so we can help each other with other options for ladies with radiated issues



So far my skin is healing no TE in yet ...I'll keep everyone post

Raelan

I'm trying fat grafting before getting TE's. I finished my rx treatment about a year ago and had my first fat grafting session the end of August to both sides (my PS wants to create symmetry so is grafting both the radiated and non radiated side). I'll have at least one more fat grafting, then TEs placed after the first of the year. So far I'm really pleased with the fat grafting results. My skin seems to be softer and the scar area that received the boost is significantly improved. Crossing my finger this works so I can avoid a more invasive procedure.

patriciahurtado

Raelan I'm so happy that your fat grafting is working... I'm hoping that it will work for me too ... So should I ask my PS to start far grafting before placing back my TE..???im missing one do to my infection... How many times have you had it done....I also would like to wait a little before recontruction... I have a square tan on my radiated side ... How long does it take for the tan to go away... It's been a month from radiation ...

BayouBabe

Just thought I would check in. My exchange was about two months ago. Fat grafting donor sites are healed and no longer sore. Breasts are dropping and fluffing nicely. Rads side is still a bit higher and tighter, but part of that illusion may be the fact that I have no nipple on that side and had nipple sparing on other. In a bra they look great. Lost a lot of the fat in the upper pole on one side, so another fat grafting will be in my future, probably April at same time I get a nipple created on rads breast. Breast is still a bit tan from rads, but it is slowly getting back to normal. Skin feels much better after fat grafting on rads side and soreness under arm from rads doesn't seem as intense. Next appointment with PS is in March after things settle in place. Hoping to be one of the rads/implants success stories - so far so good. Best of luck to all of you!

patriciahurtado

Bayoubabe... Yes .... You will be a success story!!!! So did you have fat grafting first your implants or after the implants ....... I hope that I will posting soon with some results with PS.... As I continue this journey I will posting to make sure we all can make the right decisions!!!



TGIF

BayouBabe

Patricia - I had fat grafting done at the same time as I had my exchange surgery - one surgery, one recovery.

Sparkee1984

Hi I live in Arizona and heard about charleston , south Carolina doc for micro vascular surgery is great, Margo massey is her name and does her surgerys in South Carolina but also in new Orleans at the breast center and i know teir mavhines in New Orleans are the best! I tried to get into the breast center in new Orleans with Dr. Sullivan but they are booked until after the first of the year. Apparently she is part of their group and can do my surgery soon. I am ready to go now! Any info out there about this dr Massey , thanks Jamie

Sparkee1984

Hi I'm in Phoenix and wondering what kind of surgery you had and who did your implants? I'm thinking about the tissue micro surgery but just not sure yet. Happy to hear your implants turned out good after radiation!! Thanks Jamie