Implant placement after previous radiation

Alli

Hi All,

I am dealing with a DCIS recurrence now 10 yrs after my first diagnosis of DCIS/IDC-stage 1. At the time of my first diagnosis, I was 36 years old and underwent left breast lumpectomy/radiation/Tamoxifen. Since my first diagnosis, both my mom and sister have had BC. I'm BRCA negative..

My surgical plan at this point is BMX-skin/nipple sparing followed by implant reconstruction 2 weeks later. The PS wants to delay the implant placement for 2 weeks after the BMX to see how my radiated side heals. If there is any sign of necrosis or impaired healing then she will perform Lat Dorsi flap recon with TE placement on the bad side and TE placement only on the good side.

My skin on the radiated side "looks" good but I know that the healing process may be impaired.

The hope is that all goes well with the BMX and then she can perform immediate above the muscle implant placement bilat with addition of Aloderm( foregoing the need for TE placement)

Has anyone had a similar surgical plan? I'm not excited about 2 surgeries in 2 weeks but do understand the rationale for waiting. I cannot find any other posts about nipple/skin sparing mastectomy without immediate reconstruction of some kind.

Anyone with direct implant placement after having previous radiation?. How likely is the risk of the implant surgery failing?

I was hoping for a simple surgical plan but it seems that previous radiation really complicates things.

I am truly grateful that my recurrence was found early.

Any words of wisdom would be greatly appreciated.

Alli

FLBuckeye93

I don't have experience with this, but am trying to decide about a BMX and reconstruction after having had radiation, too. I've been diagnosed with LCIS in the opposite breast Les said than a year after my first diagnosis

Alli

So sorry you are having to deal with this again so soon.

There are so many reconstruction options that it becomes a bit overwhelming.

After going over all of my concerns and questions once more with my doctors, I really do understand the rationale for having a delayed reconstruction. There will be a lower risk of infection and tissue necrosis and a higher probability that my reconstruction will be successful.

I wish you the best as you are going through this decision making phase.

Alli

FLBuckeye93

Alli,

I'm interested in what your doctor said about not doing tissue expander. I like that idea more, and haven the found a doctor in Tampa who does that. When is your surgery?

Thank you for your reply.

amyrachel

Me! I had this done! In 2011 I had a breast augmentation and lift. In 2012 I was diagnosed with bc, had a lumpectomy and radiation. Fast forward to 12/16. Cancer is back Just had a double mastectomy with tissue expanders put in on 12/14/16. My plastic surgeon explained all the risks and of course I was terrified. Every week I'd see him and he's put more saline in the expanders. So here I am about 6 weeks later and everything has been normal. My skin looks great, there's lots of blood flow, and I'm scheduled for the exchange surgery on March 10!

FLBuckeye93

Thank you Amyrachel! How do the expander feel? Do you know what your size will eventually be? My Plastic surgeon wasn't sure she'd get me to a C cup I feel I opted for the surgery.

amyrachel

FLBuckeye93, sorry I'm just seeing this. I still have my expanders in. I really don't have any pain with the expanders. They are just uncomfortable. I had a root canal last week and didn't have any issue sitting back in the dentist's chair at a decline. The thing about expanders, they are rock hard and they don't jiggle.

During my mastecomy, he removed approximately 200 cc's of breast tissue from each breast. My implants were 225 each, so a total of 425 cc's. My expanders are each holding 500 cc's of saline right now. The expanders sit real high, almost like what a push up bra would do, and they don't drop like an implant does. I plan on going with 500 cc's implants. For my size, it would be a full C cup. My exchange surgery is in 9 days! I can't wait!!!