Direct-to-Implant and complications

cait1986

Hi Ladies,

I have a question for those of you who had Direct-to-Implant reconstruction. 

I had Stage 1C ovarian cancer in 2011 (surgery, followed by chemotherapy) and was diagnosed with BRCA 1 at that time.  There is a strong history of breast cancer on my father's side of the family.  I plan on having a prophylactic bilateral mastectomy with reconstruction early this summer.   I have met with a breast surgeon and plastic surgeon for DTI and a different team of breast and plastic surgeons for implants using expanders.  As if cancer and BRCA 1 is not enough fun (!), I also have multiple sclerosis and other autoimmune issues.  My inclination is to have DTI recon and I have found a good team that have done many of these procedures together.  The plastic surgeon who recommended implants/expanders for me (particularly because I have MS) said that the incidence of necrosis and infection is higher with DTI than expanders. 

So, my question is, how many of you ladies who had DTI, recently or in the past, experienced necrosis and/or infection after surgery?  Are there any other concerns regarding DTI that I should be aware of?

By the way, I have been told that I have large breasts (38D-DD), but that they "are not that large."

I have read many threads and posts on this site, and I want to say thank you to everyone for sharing so generously.  There is just a wealth of information!

 

pkb3937

Hi Cait!

I had a direct to implant reconstruction in April of 2011.  I previously had a breast augmentation (before cancer), so the surgeon felt I was a good candidate since I already had a pocket for the implants and my skin looked good.  I did not have to have radiation.  After the surgery was a nightmare.  I had small areas that appeared purplish / black, and event a couple of area with blisters.  In the end though it all healed well.  No complications and skin problems.  I am having a revision in two weeks because I am not happy with the shape.  They are rather flar in the front . But very good size.  I am going to the plastic surgeon whom I saw for my augmentation before my diagnosis.  He is going to put bigger implants with a different shape and he is going to also do fat injections.  I'm nervous about doing this all over again.  

sandra4611

My plastic surgeon does direct to implants with enormous success...unless the patient has had radiation. Then he says only about 50% are successful. I've seen more people with infection problems from tissue expanders than implants so don't be afraid. I had large breasts. I had a double mastectomy - 4.5 hours, then the implants were put in - 4 hours. The cancer side did great. The other side would have been perfect too, but some stupid hospital employee gave me a staph infection.  The surgeries I've had have been for repairs due to the infection. It could have happened if I'd had a lumpectomy or a biopsy and had nothing to do with immediate implants.