Plastic Surgeon won't do reconstruction due to radiation

sashimi1973

I will be having a bilateral mastectomy around February 5th. I wanted reconstruction, but my plastic surgeon said if I'm having radiation, I can't have reconstruction because of the damage it does to the skin. It's probably more that he chooses not to. I know women who have had reconstruction and radiation. I know radiation can increase chance of complications. DIEP tends to not have as many issues as implants, but I don't want to have my stomach carved up. Plus, my PS didn't say DIEP was an option with radiation, either. Guess I'm just trying to come to terms with the fact that I'm going to have to go flat. Anyone else deal with this?

berries

I think you should find a new plastic surgeon. My PS has worked with me through my mastectomy and has recommended an exchange surgery before radiation as I would have a better cosmetic outcome, but said ultimately it was MY choice and he would work with me either way.

You do not have to come to terms with going flat if that is not what you want. Many (many) people have reconstructed breasts and go through radiation. I would get a second opinion and find a PS who can work with your needs. Good luck!

xx

alissat

Get a second opinion. My PS put expanders in during my bilateral mastectomy. I'm going through radiation right now. My PS has given me the pros & cons of both implants & DIEP. I've yet to make a decision but reconstruction can be done after radiation.

smc123

Get a second opinion because I had reconstruction then radiation. My plastic surgeon worked with breast surgeon and put in my expanders during my double mastectomy surgery. Then I had to have weekly fillings to stretch the skin before radiation started. My plastic surgeon said I could always go down a size with my permanent implants but never up after radiation so he filled them pretty good...btw...I ended going smaller for my final permanent implants after radiation was finished. Good luck

MinusTwo

Ditch that doc. I had expanders and reconstruction - and then a recurrence. Two years later, radiation. So not only do many people have radiation with expanders in place (the preferred method as I understand it) but I had both ALND surgery and radiation after my implants had been in place for 2 years. That side is a bit tighter now - or the other side is more saggy. Otherwise no problems.

It is true that the skin, nerves, muscles tighten up, so it may be a problem for DIEP - but don't let that stop you discussing it with someone who cares.

sashimi1973

Thank you, all. I am speaking with my PS tomorrow to give him another chance. In the meantime, I'm looking for other surgeons. It didn't sound right that he couldn't do it because of having radiation.

mebmarj

It’s interesting how everyone’s experience may differ.
I had triple negative IDC (2003) with lumpectomy, chemo and radiation in 2004, then another cancer in 2011 with bilateral mastectomy. Delayed recon in 2012. I had several surgeries due to scar tissue, muscle issues and nerve problems in the axilla. I chose to have the implants removed Jan 2017 which relieved many of my issues.

Ultimately radiation is unpredictable. When a patient has NOT had it- their course of treatment and surgery is a bit more predictable for the doctor. The chance of complications increases after radiation. Many plastic surgeons will also not take on any smokers because that complicates healing too.

Breast cancer is difficult. You have to make the best choices for you in regard to your family, job, other health issues and finances. There are many of us who have had no issues and recon has been fine. However many of us also found going without breasts is okay too.

Best wishes.