Radiation with tissue expander

Thanks Judy I was hoping someone would be able to explain it..

Another question. My PS is gradually filling my expanders before the rads start. He wants to stretch the skin as much as he can before the rads. I'm very small on top and I think that's his concern. This made sense to me; has anyone else had this done?

Also, I read a posting on this site where someone had a negative experience w/my PS. He came to me highly recommended by a friend who'd had a TRAM flap and he works w/my breast surgeon (that's all she does). They have separate practices, but he works out of her office a couple of times per month. I can't believe she'd work with anyone who wasn't good. It's so easy to second guess my decisions:(

 One last thing, did anyone get a bit of a rash w/these expanders? Mine's not consistent--it could be a lotion I'm using. Thanks for all your help!

To all that helped me out recently...I wanted to tell you all that your advice paid off.  I was able to contact another PS (outside of the Kaiser network) for a consult.  I offered to pay out-of-pocket for the consult and the PS said that he would take me at no charge!  I have since contacted a new oncologist and was able to change my insurance carrier through my work during out open enrollment period.  I checked with our benefits dept and with the carrier directly (3 times) and was assured that there would be no penalty for pre-existing condition.  Now, I have my last chemo on Monday, a MRI on Friday (28th) and then I will cancel my pre-op physical and surgery date with Kaiser for next month.  I am postponing everything until I meet with the new oncologist on the 6th of Jan..  The surgeon that I am meeting with has done MANY procedures with TE and then RAD.  I am so excited and relieved.  I wanted to thank all of you for your advice.  I stuck to my guns and didn't have to "settle" on what the HMO dictated.  The relief is overwhelming.

gfrey I was also fully expanded before radiation they say the skin wont stretch after rads as easy but after rads I was able to expand even more so good new's feel free to PM anytime.

Lainieo I had rad with te and recently just had my exchange to implants so far everything is going well my skin is tighter and a slight shade darker but all is good fell free to PM anytime.

Has anyone had all of their chemo and rads done and then gotten an expander placed and then implants?   My radiation doctor when I first saw him said the only option I had for reconstruction was DIEP and I should have researched and gotten another opinion on that. I am just wondering if anyone here was in my situation and had to start the entire reconstruction process after the rads were completely done.

It's OK Jane.  I had one fill of my TE then radiation for 28 days.  Then afterwards I continued the fills with no problem.  It's fine, but you need to put dream on your breast from the get go.

I used Miaderm (available online)  and Cocoa Butter (available in the drugstore)  and later on, TAMANU Oil (available online)  My skin stayed soft, and although tighter than the non-rads side, it is still OK.  Just remember to cream yourself at least twice a day.  JUDY

Jane - I'm currently having radiation w/TE expanded 730cc  May get another fill after radiation.  I think you'll be glad you've already got the TE.  From what I understand, it's sometimes difficult to do that surgery and stretch the muscle, skin, etc. after radiation...  Be sure, however, that your radiation oncologist is experienced radiating breast with tissue expander in place.  I'm driving a good distance to a renowned cancer center, as neither rad onc in this area had experience, nor knowledge:)  Good Luck, You're on the downhill slide, will go fast!!

I haven't posted here in a long time, but I am two days away from having my expanders replaced with implants! It has been one year from my bi-lateral Mx with expander insertion (March 2009). And after 6 weeks of radiation over the expander from July-Sept, I am now ready for exchange surgery. Can't wait! I will let everyone know how it goes...

Josirus:  Yippee Squiishy!!  Heal well and I'll follow soonafter..  JUDY 

WAHOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO

YOU ARE GONNA DO GREAT!

Hello Ladies! It's my first day back on the site since exchange surgery on Monday. I am feeling pretty good, after 3 difficult days getting over anesthesia. Slept continuously, massive throbbing headache, lightheaded, sore, but then on Thursday morning, I woke up feeling like a new person.

I was bandaged very heavily across the chest with a cushion - husband said it looked like a diaper! I did see my plastic surgeon while I was in the recovery room, and he told me the surgery went really well and the bandage was mostly to protect the fat grafts and let them take to their new location without trauma. Talk about suspense...not being able to see or feel anything through that cushion. All I could tell was that the weight and awkwardness of the stiff expanders was GONE! That made me very happy.

On Thursday afternoon, he took the bandages off. I must say I was shocked at what I looked like and then felt silly about my high expectations only 3 days post-surgery. I mean, a woman who gets a nose job first has to deal with a swollen face and two black eyes before seeing the final result, and I should have known it would be no different with breasts. But it made me emotional for a full day afterwards. There was a lot of swelling around the implants. The surgeon needed to put a lot of stitches around both implants to secure them in place, because my expanders had both shifted outwards and were too low on my chest. He wanted to make sure the implants didn't slip down into the pockets. In addition, he over-injected with the fat grafts, because typically only 80% of it takes, and 20% is reabsorbed by the body. So all in all, with bruising and swelling and fat injections, it looked like I had two square sponges for breasts. He also placed the implant on the radiated side a little bit lower than the other, in anticipation that the skin will tighten more and lift it up. I think my plastic surgeon sensed my disappointment; he quickly reminded me with pictures what I looked like with expanders and then reassured me that my breasts will continue to "develop" over the next few weeks. The implants I have in me are Allergan Natrelle 410 MM (moderate projection and height), 400cc. I was a small A before surgery - I asked to be a medium B.

Fat was grafted from my inner thighs and there is a lot of black bruising there. It is still tender and sore, and that surprised me too. I am slim to begin with (5ft11, 145 lbs), so my thighs now look too skinny! I know women pay to have super skinny thighs, but I was not unhappy with mine so it also played a role in my emotions all day Friday. Like two parts of my body had changed. My groin muscles on both sides were very sore, and given the location of the bruising (close to the crotch) I can only imagine how I looked on the operating table, with my legs splayed out...ha-ha.

But today, I am feeling better. The only pain I feel are individual hotspots near the stitches and still some tenderness on my thighs. I have a 3-year old, so any big hugs hurt too, but that kind of pain is something I am willing to take.

In terms of recovery, this was far better than the bi-lateral Mx with expanders last March 2009. From Day 1, I could get myself out of bed and reach for things. I even washed my own hair a few days after surgery. No drains also helps! I promise promise promise to get some pictures up on the photo forum next week.

I will continue to keep you all posted as my two new breasts "develop"...

Allison.. I sent you a PM

Hello everyone.  I haven't posted here for a while , but I just wanted to let everyone know I had my exchange March 17 and I have to what a relief to get the tissue expander out!!!  The implant looks pretty good and I was surprised how quickly I have been healing-definately slower on the mx/ radiated  side- the other side now has an implant to add symmetry. My radiated side is peeling like crazy, but feels so soft, I don't mind putting lotion on it!  I am still at the move gently around me stage, but I have felt comfortable stretching and exercising a bit.   For the first time since December of 2008, I slept on my side without pillows inbetween my arms and waking up two or three times to adjust.  I go to see the PS next week and will talk to him about matching up the mx side nipple with the other side. 

mom3band1g - k, you'll be glad you did recon first.  Would be much more difficult to stretch skin and tissue after radiation!  I too had immediate recon - and I knew I'd be getting radiation.  Just had last tx today!  And my tissue expanded breast looks and feels fine!!!  

I guess potential for capsular contractions still there, but  so far, so good!

Di Di 

To mom3band1g- I finished rad on 03/17/10 with implants in, and I don't have any issues with it, like capsular contractions or pain,the most important things to remember are :

1. Apply aloe right after rad while you are in the changing room and stretch out your arm and move in a big circle slowly as many time as you can during the day.  I used aloe twice during the day and Aquaphor twice at night.  I did not have any burn, only tanned.

2. Take one multi-vitamin a day, it will help you heal faster, my doc is ok with it.

3.  Not to wear bra, I don't know it is possible for you or not, wearing bra will only irritate your skin.

This is my experience, hoping it will benefit you as well.