how soon after radiation?

Hi Christine,

I am about at the same point too, I finished rads in June and actually had "forgotten" the time frame on my reconstruction!  Ha!  My Mom had been pestering me that her friend (who was a RECEPTIONIST at a doc's---NOT an onc either---years ago) kept saying to her "I don't know why she hasn't had that done already---so and so had hers done during the surgery---blah, blah, blah"! OMG I am getting pissed just typing that.  People can be SO annoying.  They have NO idea how different each person's case is.  So, anywhoo I have an appointment w/my PS Sept 10 to go over my options and a time frame.  I am going to Johns Hopkins and they do not reccomend implants if you've had rads for the reasons Jenn mentioned, as well as the high failure rate because of the skin condition.  I will probably do DIEP too, although of course there are issues there, some being the long surgery time, as well as an at least 3 day hospital stay, plus there is always a posibility of rejection.  I'll know more after the 10th and will be sure to fill you in.  I'd like to hear how you are doing too!

Take care,

Sharon

I had bilat with TE, chemo, rads and ooph.....PS likes to wait at least 6 months post rads to do exchange.....had my exchange almost 7 months post rads.....my skin has done well.....but implant fell 6 weeks after exchange and had a revision 4 months after the exchange....implant fell again, though not much, but since I didn't like the implants I wanted them out and a year later had both swapped out for smaller ones....2 years later all is well.....a freind just had a DIEP following bilat...it was a 2nd primary and she had rads the 1st time....it was a rough go for her with PS having to go back in twice, next day and 2 days after DIEP....I was afraid of a long surgery so never looked into it....my surgeon does not do them and I was not a candidate for lat flap.....in clothes, I look pretty much like I did before BC, but of course, naked they are not the same!!! and no feeling.....all the best to you...

Sharon - I just wanted to say I know how you feel about the people who "think" it's their business to know when and why we're doing our surgeries.  I'm pretty open about everything, but have come across quite a few people that don't understand my waiting.  In all honesty, I'm waiting because DIEP is a long surgery and I'd like to be in better physical shape for the surgery,  I'm tired of doctors and I wanted to spend this summer with family not sick and get my daughter off to college without distractions.  I rescheduled my appt with the PS to December because I just didn't want to deal with it right now.

Christine - I wanted to add to my earlier post that while the dr's feel that I should have DIEP, it's the decision they feel is best for me.   I reread what I wrote and felt that I sounded like DIEP is the only option for people with bi-lat and radiation.  I am no expert, I meant to just give the information I had based on my own experiences (so far).

I am going to see my PS today (BMX with expanders on Tuesday). I found out after I met with him the first time that radiation was highly likely for me… but my BS always knew this and felt that I was not a candidate for TRAM (I don't even have enough fat on my stomach to make one breast A cup let alone 2.) I'm not sure if I could do DIEP. I don't want to take muscle from my back because I already have some neck/back issues. I personally feel I need that muscle to keep pain at bay.

So in my case it seems like its implants or external prosthesis. I'll see what my PS says today. Granted there are surgeons that can take tissue from my butt or thighs (I do have fat there) but I don't want to go that invasive. That can fail too. I feel failing from implants isn't going to be as much as a disappointment than doing a more invasive procedure.

I'll let you know what he says. He does fat grafting and I have read that helps with radiated breasts (reduced capsular contraction) but that would be in conjunction with lat flap with implant.

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UPDATE:
Plastic surgeon seem fairly confident we can do implants… of course no garuntee and no radiation would be better. He feels that since I'm not trying to go large (currently an A or small and the use of fat grafting that there is a good chance he can make this work. He stated that there are arguments on both sides, one to wait on the reconstruction and one to start with the implants as mastectomy. He feels it's best to start right away. (Ironically I read that on Dr. Susan Love's site too:

scroll down to Radiation After Recontruction http://www.dslrf.org/breastcancer/content.asp?L2=3&L3=2&SID=167

He says radiation isn't quite like it used to be. They really pinpoint the area now.

My husband went with me this time. He feels this doctor is very smart and knows what he's doing… but quirky. He thinks my BS is quirky too.

Expanders first. I will be there 2 nights. With expanders there is a little more pain involved and longer surgery. I think they want to be sure I have my pain managed properly. I was told its about an 8 hour operation to do both that BMX and the expanders.

Glad I'm not going to be awake for any of this. I don't really like blood and guts

Fat grafting isn't like DIEP. It's more like they lyposuction it from one place and inject into the other. A lot less invasive. They have to put in extra because the body does absorb a lot of it. At least that is what I read online

OMG me too. BMX level I axillary on left side, sentinel on right. Maybe my doctors are older and move slower I was told only 2 myPods (my name for drains). I'm actually going out right now to fill my prescriptions:

Colace for constipation, Sofran for nausea, Valium for anxiety, Norco for pain, Cleocin antibiotic and percocoet for really bad pain. I haven't had that many drugs in, well ever! and certainly not at one time. Maybe have all those drugs in me will get my body ready for Chemo.

I'm not going to fill the Colace because I use Milk of Magnesia. If that doesn't work I'll fill it. I have a feeling I won't need the Valium and possibly the Sofran either as long as I don't take the drugs on an empty stomach.

They are planning on keeping me 2 nights granted they first night will be practically over since surgery starts at 2:45 + 8 hours= after 11pm some time. It is possible a 3rd but we are all not planning on it. I have a doctor's appointment that 3rd day with the PS.