Reconstruction after RADIATION

4sewwhat

Hi ladies!  Couple quick questions...

Bruising?  Mine is horrible. It's like like someone beat my thighs with baseball bats.  Pretty uncomfortable to downright painful too.  I didnt take pain pills after my MX or exchange so I have a pretty good handle on the pain thing, but this chit hurts!!

Antibiotics?  I was not given any this time and the area where the fat was grafted to is getting pretty red.  Is this normal from the grafting and the blood flow or should I be worried?  I don't have any bruising in the breast area but it is darker colored now and I don't know if it is from the actual fat grafting or if I need to worry about infection.

I did start taking my antiB's just in case.

babs6287

4sewwhat- the bruising is normal after lipo-and yes it hurts!!!!  I was given antibiotics but then again I've had 3 infections so for me it's definitely needed.  Where they inject the fat it gets a little redder than the other areas.  But the key is-is it warm to the touch?  If not, then it should be fine.  If it is then call your PS just to make sure

Babs

4sewwhat

Thanks Babs,

I expected some bruising, that particular one just seemed really up there on the scale!  Plus he did inner and outter on both legs.  It doesn't help that I have basically been on the go since he got done!  Tomorrow  is a do nothing day for me!

The red area is not warm or hot. It's kind of shiny but very soft and smooth.  I will send ps a message and maybe a pic, but I think I will do some antiB's just in case too.

Thanks again!  Hope you have fun plans for the holiday!  I want some BBQ!

Lynne

babs6287

I too would love BBQ  We moved into an apartment about 2 years ago and no BBQ allowed!!! Bummer!!!!!!

This time for the fat grafting the PS took fat from my midriff, flanks and my back-it really hurts and it is so hard to get up or into bed.  I haven't black and blued yet but last time I was really covered with bruises.  I think taking the anti-biotics is smart-better safe than sorry!!!

Have a great holiday!

Barbara

4sewwhat

You too!

I prolly would not smart so bad if I had not just spent 3 full days chaperoning 9 kids at an Anime convention downtown.  I sat as much as I could but you know how that goes!

I can live with the bruises and feeling like hundreds of bees are stinging me when I shift positions.  I just wish I could tell he made a dent in my thighs!  I know the lipo was not the main purpose of the surgery, but help a girl out!!  I hope you don't bruise too bad and it let's up soon.  I am going to try to get some Arnica gel tomorrow.  I don't know if the tablets are helping or not?

Enjoy tomorrow Babs!  I bet you can find some good take out BBQ!

Raelan

4sewwhat - Congratulations on getting through your fat grafting session.  My PS didn't take any fat from my thighs/legs (yet), but I recall reading some other posts by ladies who did have lipo to that area and they commented on a lot of bruising.  I do think it's very common, and being up and about like you have been may be contributing to the colorful pattern you have on your legs.  And yes, it can be pretty sore and swollen for a couple of weeks where the lipo was done.  It took about 4 months or so before I really saw the benefits of the lipo from the areas where the fat was taken (in my case the abdomen and sides).  Also, both breasts where the fat was injected were red and swollen for about 2 weeks.  I also experienced some slight bruising where the fat was injected.  But all in all, I found the recovery from lipo to be pretty easy peasy.  Sore for about a week, then just a slow reduction in bruising over time.

It's exciting that you're at this stage of the game.  

4sewwhat

Thanks Raelan!

I figured all was pretty normal but thought I would ask you girls!

My PS seemed really pleased and excited we were at this point. I see him for a 3 week follow up on 6/12. 

How are your TEs treating you?  I need to get some pics on thr forum too!  Never enuf time but that's a good thing sometimes. It means life is moving along at normal speed!

Have a great holiday!

Raelan

4sewwhat - T.E.'s really don't both me at all.  Sometimes I even forget they're there.  My biggest challenge at this point is figuring out how to disguise them.  My PS doesn't want me wearing anything constrictive (i.e. a bra), and only wants me in a loose camisole.  So, I've had to get a bit creative.  I actually took the foam inserts out of my genie bras and pinned them to my camisole to give myself some shape and to hide some of the odd bumps and lumps that come with T.E.'s.  I figure this is all temporary, so really only a minor inconvenience at the moment.  I'm so thrilled to be done with my prothesis that I conside this a very minor hassle in the overall scheme of things.  

Jill_MN

4sewwhat - I've had 3 fat graphs and, yes, that bruising is very typical. Congrats on your progress.

quiltrunner

OUCH!!!!  Get some Arnica gel and it will speed up the bruising process.  I took oral arnica and bromelaid (I think that's what it's called) and I didn't bruise too badly.  The arnica gel is a topical.  Good luck ! 

4sewwhat

Thanks ladies!

I have been taking the oral arnica and pineapple enzymes. I have now added the topical gel.  Really that one leg is the worst.

My LE PT lady is thrilled with the results so far.  My LE is behaving a little better and she thought the whole breast area looked really good.  I don't see PS until 6/12. 

I do have to admit I am a little disappointed with the donor sites!  I kind of feel like for all of this I should notice some difference in my thighs. I know there is swelling, but still. I wish I had stuck with having him do only one leg this time and the other the next!  That way only one would have hurt at a time and not both legs at the same time more than once!

Raelan!  Great news about the TEs!  Mine never bothered me either.  When they were overfilled they were just unforgiving and in movable!  But never hurt.  Glad to hear you are doing so well

Oh, also, Walmart sells cute camisoles in a bunch of diff colors that have the pockets and the pads in them.  They were in the jr (5,7,9,11,etc) section.  They are a little long but they are cute with lace on them.

peacestrength

Hi ladies - I haven't had time to read past posts but I have a question:  can TE's and implants be placed after I've had radiation?  

Here's my situation...I didn't want immediate reconstruction, in fact I have been leaning toward 95% no recon leaving 5% open to the possibilitiy.  Well, I've been thinking about it much and wonder if I can have just TE's and implants...My PS said that lat dorsi was my option almost a year ago.  Before seeing him again, I wanted to ask here if you think it's possible to have just TE's and then implants placed? ...without fat and muscle. My radiated side skin looks really good - it is slightly darker still...not sure about the tissue under skin though.  I really don't want to go through lat dorsi surgery at this point - future, maybe.

Thanks for your input!

Jill_MN

Peacestrength - that is similar to my situation. Had lumpectomy & rads on Right breast in 2012. Then 3 fat graphs to repair damage. They found cancer in my Left breast last month and were concerned about reconstruction due to the irradiated tissue. First PS really pushed Latissimus Dorsi Flap; second PS seemed very positive about TEs then implants. He feels the fat graphs helped reverse some of the damage from the radiation. I had a NSBMX on 5/29 so am still in the recovery stage. The radiated side is definitely tighter than my left. I'm happy to post my progress. I see both the GS and PS on Friday. 

Best of luck with your decision.

- Jill

babs6287

Peacestrength- I had mx on left with full lymph node dissection in 8/12 followed by chemo and radiation.  In 8/13 I had pmx on my right and TE placement.  Drs wanted me to do LD but I would not.  Couldn't do DIEP due to abdominoplasty many years ago.  The road for those who opt to do what I did is not always an easy one.  Having FGs really helps the radiated skin.  I lost my TE on the left due to infection but have had 2 FGs since-which has dramatically improved my left side.  If you chose to go this way have the FG before TE's  I think that's the better way.  Good luck in whatever you do!

Babs

Jill_MN

Peacestrength - babs6287 makes an excellent point. FGs should be done prior to TEs. I had 18 months for the FGs & the stem cells to work their repair magic before my second cancer was discovered. You want your skin in the best possible condition. Plz see at least 2 PSs for opinions. (My GS really encouraged this.) I chose 2 from different clinics to ensure objective opinions. Good luck & plz keep us posted on your decision. 

Raelan

I agree with what everyone else is saying about the need to have fat grafting prior to TE placement.  This process certainly isn't for everyone, particularly because it requires a great deal of patience.  I'm 2 years out from my BMX, and don't expect to be done until year-end (knock on wood).  However, the longer you can allow the radiation damage to heal and the fat graphs to work their magic, along with a very slow and low fill process, the better off I believe you'll be.  I waited for a year after radiation for my first fat graph, and then had a 3 month break between first and second fat graph and final TE placement. 

So far I'm pleased with the way my radiated tissue is responding.  It's not exactly the same as my PMX side, but it'll pass.  My PS says my PMX side is an "A+", so the bar has been set pretty high. 

peacestrength

Wow, thank you all for sharing - I so appreciate it!

Questions: where does the FG tissue come from?  Can it be taken from thighs and butt areas?  I carry most of my weight in these two areas. How is the FG placed before TE?...just under the skin or under chest wall?

Raelan

peacestrength - The fat can come from anywhere, although PS's seem to prefer the abdomen or thighs (easier access and plentiful in most cases).  In my case it was injected everywhere within the breast area; skin, pec muscle, under arm area where lymp nodes we removed.  The goal is to significantly reduce or eliminate any radiation damage, so where ever you were radiated is where the fat needs to go.  This is why it's best to do more than one fat grafting session.  Generally, there's a maximum amount of fat that will take in any one session.  In my case, my PS put about 100 cc's in each time, for a total of 200.  He also did the prophylactic breast so they would have a uniform look.      

bellydancer

Hi!

Peacestrength, I am 3 years out from my radiation and have been offered Diep with implants as an option.  PS has told me there is a 70% failure with this due to the radiation. 

All the best with your decision.

babs6287

yes. Radiation is most of the cause for recon issues. My first FG was from thighs He got 300 cc s that time. This time from love handles and upper midriff. Don't know how much he got but he said not as much as last time. And now I'm out of fat. He injected all over my radiated left breast area and tried to use the fat to lift my scar. I do have upper pole fullness and some side fullness which had been soo very tight prior. The scar lifted but is still down. I have hills and valleys that we hope a small implant in 3-4 mos will fix. Time will tell

Babs

Jill_MN

Hi Peacestrength - Many PSs will only take fat from the abdomen as they believe the BEST stem cells reside in the lower tummy. I sought out a 2nd PS who was willing to collect fat/stem cells from inner & outer thighs & muffin top sides which was important to me as I knew I needed 3 FGs so multiple harvest locations were required. Fat grafting uses a non-ultrasonic cannula method in order to NOT kill the stem cells. The fat is then filtered using a pure graft filter bag or centrifuge system. The blood, fibers, & other unwanted fluids are then removed - leaving nice, pure fat (hopefully chock full of stem cells) ready to inject into your breast(s). The fat will be injected under your irradiated tissue...I'm guessing throughout your rectangular area where you had your rads. You'll wait 3-4 months between FGs to allow your stem cells to work their magic. You'll need to ask your PS how many FGs you'll need to get your skin in the best possible condition for TEs. You may need to consult with more than one PS. 

Please know two things. One - the medically necessary fat grafts do not leave the patient looking like a model. I've had 3 FGs so I would have thought my thighs would have been significantly thinner. They look fine but since I wasn't contracting for a mommy makeover, my entire legs were not lipo-sculpted so I will not be walking any runways soon. My belly was pretty flat to start with but now I have a little skin ridge just over the belly button from the PS digging around for fat. Secondly - there is good fat - smooth, creamy, etc. (my words, not the medical community's) and then there is fiberous, stringy fat. My PS told me she had to hunt for good fat. No one knows the quality of their fat until it is removed and examined. To the average Joe (or Jolene), fat is fat...right? Hopefully, you have beautiful, high quality, stem cell filled, non-fiberous fat.

I just received access to the photo forum & will try to figure out the registration process & then post some photos. I loved my FGs because my PS scraped out the painful scar tissue that was located under my bra line & she filled it in with cushy fat. (Well, as cushy as a B- boob can be!) I was very happy w/ my FGs but it proved to be somewhat futile since I ended up needing a BMX. At least the FGs had 18 months to repair the irradiated tissue. Hopefully, the FG photos will allow other women to see what can be done for lumpectomy divots, etc.

Hugs,

Jill

Raelan

Dang it.  My left TE has a slow leak.  I thought something seemed off and went in today for my 4th fill only to have confirmation it's deflated and will need to be replaced.  The only silver lining is the fact it's not my radiated side.  

So, surgery is scheduled for June 20th (2 weeks from now).  Should be a relatively easy surgery, but I still have to be put under.....4th time in a year.  

My PS is P.O.'d.  Said he hasn't had one of these for several years.  I'm getting to be an old pro at this surgery thing.....not something I really strive to be good at.

So, just a slight setback.  I'm not going to get all wrapped around the axle about it. 

Jill_MN

Raelan, I'm sorry to hear you need a replacement.  I would think quality control on TEs would be so stringent that this shouldn't occur. Keep your positive attitude. I wish you well.

Jill

4sewwhat

Aw Dang It Raelan!  That's a bummer.  So glad it's not your radiated side though.

I know what you  mean about being apro at the surgery.  I have been in the OR 5 times since New Years.  That was my swap and I was supposed to be done for a while!  Well.......we see how the best laid plans turned out!

I am 2 weeks out from my fat graft.  My thighs look no thinner but the bruising is fading. Slowly!  It's a shame, we should get that Mommy Makeover for having to endure the rest ;0)

I keep looking at the right breast and waiting for it to "do" something!  I'm just not sure what!  LOL!  It's going to be a long couple of months waiting for it to percolate!

I see my PS next Thursday for follow up and I will report in with his take on things.  He apparently is as curious and anxious as I am because he couldn't wait and had his office manager call me Tuesday to check in and see how things were shaping up!

babs6287

so sorry Raelan. It's a bumpy road but glad it's not your radiated side!!!!

Babs

quiltrunner

Raelan, was the TE detective?  What a complete bummer!!! So sorry you are having a bit of a setback.  

Raelan

Quiltrunner - We won't know what caused the leak until we get the sucker out.  These things should be able to take quite a bit of abuse so it will be interesting to see if it's due to a defect or if my PS accidentally poked a hole in it during one of my fills.  

4sewwhat

I go for my 3 week follow up Thursday!  Bruises are almost all gone :0)  I'll let you all know what he thinks of his handiwork and my prognosis!!

Hope you all are doing well and enjoying the summer so far!

Raelan

So I've  now gone 4 weeks without a fill and I have to say that my radiated side has really softened up over the past month.  It's pretty pliable and I can even get a little jiggle out of it when I move it around.  This is a good sign.  Even though I've had to take a slight detour due to my TE leak, in some ways I think it's helping support a successful expansion on my radiated side.  Low and slow is really the key in my case.

quiltrunner

Raelan, I'm glad to hear there is a bright side to the setback.   

I'm scheduled to get my TE surgery on 7/3!! I moved it up from 7/10 because I would really like to have this finished by year end to hopefully avoid another deductible in 2015. Every week seems to count! In your opinion do you think my goal is reasonable even assuming there may be little setbacks here and there?