Radiation & reconstruction questions

Hi there... I have implants and am currently doing radiation. My surgeon prefers doing the implant surgery prior to radiation, because she would rather work with unradiated skin since it can be hard to work with skin after radiation. But there are many people who get implants after radiation as well if the skin is still in decent condition. In that case, most surgeons usually like to wait 6 months to a year. But all that to say, it is definitely doable and has been done! So I'd say if your PS is refusing to do it, then talk to another one.

I had a TE placed prior to radiation. It was overfilled to help in case of tightness/ shrinking after the radiation. Next month I will be getting the TE exchanged for a silicone implant. My surgeon will be doing fat grafting during the exchange surgery. New evidence shows that the stem cells in your fat can help with radiated tissue. Do NOT give up hope - get a second opinion BEFORE you have your MX. Sending hugs and luck your way!

I'm 5 years out, so a different perspective.

I had a bilateral w/ immediate reconstruction, then rads. Not optimal, but it was the right choice for me. I had 3 small kids and just couldn't wrap my head around a flap surgery. My feeling was that is the implants didn't work, I wouldn't be in any worse shape than if I didn't do reconstruction... if they worked, even just  for a few years, i could get out of the immediate crisis to make better decisions.

Like you, I didn't have enough belly for bilateral reconstruction using my own tissue.

Plastic Surgeons will ALWAYS say they prefer to do some sort of flap using non-radiated tissue over implants w/ rads. That isn't to say they won't give it a try, but you should be aware that the chances are about 50/50 of the side with radiation surviving IN GOOD COSMETIC shape for more than a couple years. Generally, any assymetry can be masked with a slightly padded bra, but, again, not optimal.

If your priority is symetry and you are gettig rads, your best chance of LONG TERM sucess is a flap. You can do implants, then rads... but if you go that route, you have to go in with eyes wide open. I did, and I don't regret my choice, but 5 years down the road, I do need to have some scar tissue cleaned out or perhaps move forward with a flap. My implants don't look terrible, but they are very, very firm (both sides, not just rad side), have shrunk a bit, and have projection issues.

Good luck!

Hi slick chickie. I'm new to this site and just posted to a couple other breast reconstruction links on this site. Don't want to bore people with a repeat of my procedures, but I think u can avoid tissue transfer for your reconstruction. If u have mastectomy and later want reconstruction, I had fat transfer from flanks (a syringe of fat basically) which was put into my radiated tissue to regenerate stem cell growth and repair the damaged tissue. This allowed for expander and implant. On the other side I had a prophylactic mastectomy ( including removal of nipple to further reduce chance of BC) with immediate implant and some alloderm was also used. Then I had areola and nips reconstructed on both sides using labia. Amazing new techniques and the more people aware of our choices the better. Best of luck in your decision.

Hi all,  just finished my last chemo.... Done neoadjuvant ... Scheduled for BMX on 7/1/14.  Still in FL and meeting scheduled with my BS, who is a close friend and the reconstructive surgeon in NYC.  I checked in with Wippetmom about implant suggestions, but I think using my own tissue might come up for discussion because I do have some spare!! Thighs, not belly.  Any input on my options? How long is the recovery if I use autologous tissue.  How bad was the recovery from the additional surgery.  Looking back would you have opted one way or the other?  It's happening soon, help!  Thanks!

Thanks Dixie60,  I think I'm just a little nervous because so many decisions will have to be made the day before surgery.  I have all my NYC appts the day before surgery!