Reconstruction after RADIATION

Sparkee1984

I'm new at this first time just joined this site. Can someone let me know if I'm doing this right? Inquiring about micro vascular surgery and will go anywhere to get the best Dr. Does anyone know about Charleston, South Carolina Dr. Massey ? Any help is appreciated !! Jamie , Arizona.

Kat-ski

Jamie,

There are three places in the US that have great outcomes from tissue flaps.  Here are their links:

http://prma-enhance.com/  This is in San Antonio.  I have decided to go there.  My daughter lives there and she was having a fit b/c we can stay with her during recovery.  I have an in-person consult with Dr. Pisano in November and will start reconstructing in Feb. 2014 ( I am ready to get my show on the road and completed at the end of 2014 barring any bumps)

http://www.naturalbreastreconstruction.com/  --I consulted with Dr. Kline and I liked him and his approach.  As per remark above, I was in a bit of hot water with daughter.

http://www.breastcenter.com/   --I have been in contact with them.  I think I might have had insurance problems.  Not sure.  This team in NOLA has been highly praised about their skills and tricks-in-a-bag.

http://drmarga.com/   --I did call her but since she does the first surgery in Charleston or New Orleans, she slipped through my cracks.  She does not take medicare from what I have read.

Do not be afraid to call and talk to someone in these offices.  They are very friendly, understanding and informative.  Just take your time and decide what tissue flap you want and go from there.  The contact person will walk you through all of your questions.

I hope this helps.  Kat

jacee

Jamie, Dr Massey did my bilateral DIEP reconstruction. She is the most amazing Dr! I had 3 surgeries in Charleston, then nipple tattoos in NOLA with Vinnie. If I can be of help, please PM me. Her office can assist you with questions, insurance, etc. drmarga.com



Joni

Sparkee1984

Well that's great to hear! Thank you so much for responding! I have a consult with her in a few weeks. I was originally going to New Orleans to Dr. Sullivan and they can't see me until next year and then heard about her and that she works with them and is also great! I live in Arizona but don't care. Happy things went well for you Joni!



Thanks

Jamie

Sparkee1984

Thanks so much for your reply. Yes it helps a bunch! I made a consult with Dr Massey in a few weeks. Glad to hear good things! Jamie

patriciahurtado

Good morning my ladies ... How us every one doing ??? I get to see my PS in the 16 of October to see what he says about my radiated skin hopefully I'll get hood news ... So far my skin still has the square tan.... It's been a month and a half since radiation... Keep us updated ladies

patriciahurtado

I will continue to post see if anyone has any input... I went to see my PS but he was a no show and he had 7 appointment s at 8 am and I was one of them.. Sick of him ... No respect but any ways my skin seems to be healing fine I still have that tan square on my chest ..... Made couple I of appt with different Ps so will see what they say..... Keeping posting

BayouBabe

Patricia - you deserve a better PS than this. Glad you are looking for a new one. I switched PS - had one for my TE placement and another for my exchange. Long story with my first PS, but I had had enough. Worked out fine - I am so glad I switched and am so happy with the results. Sorry you are going through this, but it may be for the best. Good luck!

Summer-sky

I am going to see a surgeon for nest Friday for a consult on bilateral mastectomy with reconstruction after radiation. I was never told by my medical team that reconstruction with implants after rads was frowned upon. I always felt that it was an option I could have in the bank for a later time. I do not want to go with the other methods such as tram flap, etc. I am only 43 years old and naturally a large C cup size. I have been taking Tamoxifen for 8 months and just quit because the side effects were intolerable. I'm not sure that and elective mastectomy will lower my risk of re-occurance, but it may make me feel better about my decision to stop the drug.

Who has done this surgery after radiation, what was the exact method and outcome, and what questions and knowledge should I be armed with when I go to see the plastic surgeon next week? She's already sent me a pamphlet with tram flap information, and that is definitely NOT what I am looking for. Any help from someone who has been down this road would be greatly appreciated.

BayouBabe

Summer-sky : you need to find a PS who has had lots of experience with working with radiated breasts. If they have not, keep looking. Also, be sure they have experience with fat grafting; this is what has made all the difference for me. Ask to see photos of his/her work ON radiated patients. I am only a few months out from my surgery, but have wonderful results! Doing a flap was not an option I wanted to consider. And I agree with you - they keep so much info from us going into rads. So not right. Knowledge is power!

Summer-sky

BayouBabe,

Thanks for the input. I will bring those points up at my meeting this week.

summer-sky

patriciahurtado

summer how did it go... I went to see a different PS and told me that I should go with DIEP... I told him that not want I want .. I spoke to him about fat grafting and he said we can start that ... I asked him how many surgery his done he said 40 DIEP ... I don't know if that's a lot or not but he did say I did my homework and Fat grafting would be an option to help the skin ... But that all he said never mention how it would work later... I'm where u are at I don't want DIEP other anything else ... I'm still looking keep on posting We are going to find someone.... Bay... Where r u located .. Maybe your PS has recommendations in Miami or maybe we can talk to him to help us... I can always fligh and get it done... How long after ratiaded should we wait... He wanted to start the fat grafting the end of November .. But I thought it was to soon cause I finished radiation on 22 of August 2013

Thanks for helping us out

BayouBabe

I had to wait approximately 6 months after ending rads to do exchange and fat grafting. Results are still fab! I am anxious to do second round of fat grafting in April - lost some above one implant, but looks like most has stayed put. My PS is Dr. Dennis Hammond in Grand Rapids, MI. Another PS I saw wanted to do fat grafting first, followed by implants/exchange a few months later. Keep looking ladies. Maybe pm Whippetmom. She may have suggestions for PS in your area that deal with rads girls.

patriciahurtado

summer-sky any luck??

patriciahurtado

bayoubabe... Where can I find her ....? Whippetmom??

dayzoo

Here's my story - to make it short:

2009 - Lumpectomy (right side) Chemo, radiation. I was 37 at the time, and was positive it was the best choice at the time. I didn't know until afterwards that I was triple-negative, and that my chances of recurrence were increased because of the TNBC. Wish someone told me more about that. Anyways, that's water under the bridge.

2012- Found a lump in RT breast again. Unilateral mastectomy Dec 2012. Chemo again. Reconstruction - saw my very experienced PS, and he recommended Latis Dorsi with expander. Ok, sounds good - had my surgery Sept 2013. My TE's are now overfilled, and I'm happy with the size, but I was kind of hoping for a little larger.

Went for my exchange consult with PS yesterday. He told me to expect the implants to look smaller when he was done; I asked for a little larger, and he said even with the extra tissue added to my breast from the LD procedure, there was only so much he could do because of the radiation damage to my tissue.

To be honest, I am disappointed and trying not to be hearbroken about this, and I understand what he's saying - he doesn't want me to come out of surgery disappointed, but I already am.

In hindsight (HA!) I'd have done the mastectomy and skipped radiation; I had no idea radiation would create such long-lasting damage, and I do not recall being told about the possible issues I may face in reconstruction, but it's entirely possible they did tell me...lol..

Guess that wasn't really short after all - sorry! I hope this helps a little, and I hope you can come to an informed decision...

Angie

Toastiecat

Thanks for starting this thread Patricia!

I had a BMX with expanders in August, and got fully expanded, then developed a seroma and an infection in the left (cancer side) expander. Changed it for a new expander in December. Did rads with a less than full expander, to allow for tightening. Had a worse than normal reaction to rads. Incision site started opening in May (5 months after surgery!) so exchanged to soft saline implants, an cut away bad skin. Incision opened again. Tried another implant. Same problem. In August took out the implant on the left. Had a seroma since then (basically seroma the entire time.) Plan is to start over with an expander at some point.

Seeing my PS today...I'm glad I read about the fat grafting pre-TE here, I will talk with him about that. Also need to talk about sclerotherapy for seroma, and wat to do about my mounds of scar tissue. Don't think I can get expanded with that in there.

Arg! Is anyone considering scrapping the whole recon thing altogether?I feel so ambivelent about this...my right side has taken everything fine, and I'm not really thrilled with the way that looks either. If that's what I'm shooting for I just don't know if it's worth it.

hwhranch

I had my mastectomy in August of 2011 followed by 33 radiation treatments in September 2011. It ended up being November 2012 before I had my other mastectomy and reconstruction. I was told I would have to allow at least 6 months but I'm glad it ended up being longer. My reconstruction was better for it. It's been 2 years since radiation and the square tan from radiation is still visible.

taraceta28

first of all hellllooooooo patricia! i havent been on here in awhile and needed to vent about my surgical malfunctions after rads and found your forum.

so i had bmx with expanders 5/12. wasnt supposed to have radiation but they convinced me it was needed. so afer going through the agony of all the fills i had to get half of my radiated side out because my skin was too tight. i finished my radiation in september. had my exchange 4/13. i was healing good but hated the results. my radiated side was smaller and deformed looking. ps said he could fix it but they had to rest so i had to wait 4 months. then out of the blue in august i had been healed for weeks, my radiated side was red, painful and fever so i went to er. had an infection. ps took my implant out at bedside (horrifically painful). gave me a dose of zosyn and percocet and sent me on my way. ended up back with fever and pain and admitted with sepsis 2 days later. so now my surgery is pushed out until 1/14. he wants to do a tiep and use lipo from my belly to give it fullness on the top. sounds painful. im ready to just have him take it all off at this point. 

patriciahurtado

my ladies don't give up... I'm going to find a fix for our skin ....

sciencegal

http://www.miamibreastcenter.com/history-of-fat-grafting-to-the-breast

Patricia my gosh I was just reading through this thread- if you are in Miami you are so lucky because the world expert in fat grafting for breast reconstruction is there- Dr. Khouri. He literally "wrote the book" - I pasted the link above, and he has done more procedures than perhaps anyone else.

My plastic surgeon trained with him and has immense respect.

Good luck!!

JessicaS

Kestrelgurl, I am having the same procedure this Tuesday. I had a bilat mastectomy in March 2011 followed by radiation. I live in Toronto and as far as I know this procedure is only done by one PS up here. I have had 2 prior microfat grafting procedures and on Tuesday I have my TE put in. I am taking 2 weeks off work so I hope enough time. I was just wondering about recovery and ability to exercise etc. I work and have 3 young children. Also how big were you able to go? This is my silver lining to everything as I was pretty small before my diagnosis.

dayzoo

JessicaS:

Who is your PS?

I'm east of Toronto, and my PS travels to Oshawa weekly for reconstruction, etc. surgeries too. Just wondering if we have the same doc! (Dr. Derek Ford?)

Girlstrong

Wow..you ladies are amazing.  I have learned so much just from reading this thread.  I am looking to finish up chemo in December and then hoping for my surgery in January sometime.  So far I have met with 1 PS (right after I was diagnosed and didn't hae any questions for him....).  I now have 2 more PS appointments scheduled and have a list of questions.  I get confused about the timeline since I may also be having radiation.  So if I am understanding correctly the timeline goes something like this.....Surgery with Tissue Expander's place, heal, radiation, wait 6 months or so, fat graft, heal, exchange?  Is this right or am I way off base?  Please advise ladies...I am new at this. 

patriciahurtado

sciencegal.... I wish that I can actually see him next year I have Aetna insurance and dosent take Aetna ... I'm so tired of looking for PS I saw 3 already and they all want to do DIEP I don't want to that is not a choice for me.... I don't know where to look anymore I'm so sick of this issue... I would to see your PS for options help!!!

Girl strong my advise would be very patient do all the research and ask all the questions take care of TE... Be very careful with TE infections

sciencegal

Hi Patricia - Gosh that sucks re the insurance, I sure wish these companies didnt get to dictate so much of what happens in our lives. Can you switch insurance companies? I know that is a huge endeavor but everything is shaken up and changing right now anyway with obamacare.... I have to change mine too because my University where I work will no longer offer Bluecross. (not Obama's fault- our university's). 

Girlstrong your timeline is correct and the way it is usually done. I study tissue healing for my job (at the molecular level- sorry I am a science nerd) and I was super worried about healing up after radiation. So I pushed them to do my reconstruction from tissue expander to implant prior to rads. They felt that as long as I started rads within four months of finishing my intense chemo I would be okay (still on herceptin).

I feel good about my decision but it might not work for everyone.

Just know that there are options!!!!

Hugs

Girlstrong

Hi Patriciahurtado: not sure if your able to travel but I've heard amazing things about the Center for abreast Reconstruction in New Orlreans. People come from all over the world; they work with a multitude of insurances and the docs have pioneered new techniques for reconstruction. There is a thread called "NOLA in September" that gives great info on this place. Good luck girlfriend!

www.breastcenter.com

patriciahurtado

thank you I'll be seen a new ps next week.. Not sure I got an appointment with dr khouri the pioneer of fat grafting his charging me $150 for consultation ... Not sure if I should go and get his opinion and then figure out how I'm going to pay for the reconstruction or what just so confuse?!

kareenie

ask dr k office. i believe they dont balance bill even if out of network.

RCF22291

OK Ladies, I can use some advice or hopefully some experience....

My radiated side implant came out 3-1/2 weeks after exchange. I completed radiation 12 months ago, PS wanted me to wait a year before implants. Right now, it looks like capsule contraction caused the implant to push out. I had a replacement implant put in the next day.

Has this happened to anyone? How did it work out?