Reconstruction after RADIATION

Jill

My first fill was at about 4 1/2 weeks out.  My PS was concerned with the radiated side so he went low (50 cc) and slow.  The second fill was 4 1/2 weeks later.  Unfortunately, after the 2nd fill I developed cellulitis on my radiated side and the TE had to come out.  My PS and I think it was due to the poor skin quality from radiation.  I've had 2 fat grafts and my skin now looks sooooooo much better!  Waiting 3-4 mos after the last FG to do the next step.

As most of the women on their site will tell you there's no rush.  Go slow and go low!!!

Babs

Hey Ladies!!

QuiltRunner!  Awesome news on getting your cute PS to schedule your TEs!!

Raelan!  Love your attitude!  I am a firm believer that things happen for a reason!  I still feel like I lost my implant so that my PS would be pushed in this direction with me and will be able to help so many others that come after me!

Babs!  Slow and steady wins this race for sure!!  When was your last graft?  Are you getting close to your expanders?

Jill!  2 1/2 weeks is still so recent!  I know it seems like forever sometimes.  I can't speak as to when it will soften up because when I went through my MX and TEs I had not been radiated yet.  It should lessen soon though because everything in there is getting healed up.  When I had my actual implants placed the radiated side stayed tighter.  I did see a study that I can try to find again for you.   It basically was where they were expanding fully and then doing a fat grafting with the TEs still in place.  Then the  waited 3 months before doing the exchange.  The ladies in the study had great success keeping their implants even after radiation.  I think that is the study I showed my doc that gave him the final push onto this path with me!

Speaking of my PS!!  I was him Thursday.  Unfortunately he was headed into unexpected surgery and the lady was already in the OR., so we didn't have much time!  He said he injected 208cc of fat!  he even went a good way down below the breast and around the edges to get to that radiated skin.  At first he looked a little discouraged and said he didn't know where it went.  He explained that the fluid that gets transferred with the fat gets absorbed.  We also talked about the fact that I also have that fluid pocket under there where the implant used to be, so maybe some fat pushed back instead of forward.  He looked at the calendar and said he needed to quit being so hard on himself!  It has ONLY been 3 weeks!  It seems like months ago though!

He said he plans to do it again around the 4 month time frame.  He flopped on me there because he had said 3 months before.

He ended with saying that he was very encouraged!  Told me to make a 3 month appointment.  I of course made that appointment for 8/12!!  Not quite 3 months from my transfer date.  I figure by the time they can get me on his surgery calendar at that point it will be between 3-4 months!

I too am trying to work on the calendar year/deductible time frame!  I am going to ask him if we can do the revision to the left at my next surgery so that going forward into next year the surgery has a lower price tag!!  My left girl has made herself a little too comfortable and settled in a little to much!!  Needs a little lift and some fat to the upper pole.  Nothing major I hope!

I am also going to speak with another PS that my LE therapist sent me to.  Dr. Wang is doing node transplants!!  She takes a small number of them from the neck and moves them to the armpit!  Apparently there is a very high concentration of them in the neck compared to the groin for the amount they have to filter.  If they take the lower ones the patients are having LE issues in their legs, but from the neck they are having no issues to speak of.  I figure it can't hurt to look into since the compression garments don't seem to help me.  My hand swells and nothing works there so I just have good days and bad days.

OK, long winded am I!!!  You all have a wonderful end to the weekend!  I am going to try to add some pics from my phone.  Still need to get them on the pic forum.  Still need to ketchup on SO many things!!!

Hi everyone,

Thank you for sharing your stories! It's been so helpful to read what you all are doing. 

I took a break from recon while I participated in a clinical trial. Now my first FG is scheduled for 6/27. I'm suddenly feeling a bit nervous about it...I guess because it's been a while since I had surgery (which is a good thing of course!).

If I can swing two a cup little mounds with just fat, that's my goal. But I am also very heartened to hear about the success you ladies are having with the TEs so far. For people that are going that route, how much skin do you feel like you had on the rads side to start out with?

The main thing that interests me about FG is that some women have regained sensation in the breast. Have any of you experienced that?

Thanks ladies for your honesty and generosity in sharing!!

xo

Babs6287 - did you decide if you're going to try the TE again? I had my first fill on Thursday (4 weeks out from NSBMX) and decided to only do 50 cc. It hasn't been too bad on the rads side but so glad I didn't do a full 100 cc.

Wishing all the best.  - Jill

Hi Girls!

Toastie, hope you are feeling well!  I am 5 weeks out from my first AFT and it didn't slow me down much!  Just general soreness from the bruising.  A couple spots hurt worse than others.  Nothing I ever needed pain meds for though.

I have been itching like cray cray~! and Skin is very moddled and red.  Gets redder as day goes on.  Not warm and no signs of infection.  It got dark when I had the infection and has not gone back to "normal" so I don't know what's up with that.  I am taking the itching as a good sign of healing things going on in there!

I was my LE therapist and she was so excited to tell me she is seeing more fat graft patients from the PS at my hospital!!  Hopefully I started a new trend :-)

Going to see my BS on Tuesday because I have found a lump on my left side :-(  There is an implant in there and it is the prophy MX side.  It is about an inch under the areola and no where near the armpit so I am not too concerned.  I am hoping it is something dumb like a stitch that never dissolved and it is now working it's way to the surface.  Just one more thing to keep up and deal with! Cuz, I mean, who needs a break from having docs appointments every week or two!!!

Hope you ladies are having a great weekend!

Patricia,

This is what I have learnt about Fat Grafting mostly from my PS and a few patients I have met who have had it done with other PS. It not done with a TE. It is done in either the final stages of recon to help fill areas from Flaps and soften and fill in areas around  implants.   Or it can be done to fill in a whole breast.  It is called the Brava method and there is an MD in Miami  that specializes in it.   The fat is harvested with lipo from your fatty areas.   I am not aware of Fat Grafts reviving any cancer cells.  I have a DIEP and I was told fat alone does not get cancer.  Remember by the time we discover our cancer, it has been there awhile, which is why chemo and rads are recommended to kill any loose or stray cell left behind after a surgery, or to shrink before. The cancer in our breast came from the ducts or the lobes or IBC. If it was invasive it spread out into the fatty tissue or nodes. Which is why a reocurrence can occur after mastectomy(low percentage), because they say that it is very hard to remove all breast tissue.  Flaps have been around for over 20 years and I don't believe that there is any study that says that the fat/skin transfer can cause/feed a cancer cell.  I would be interested in the link if anyone does see such a study.

take care,

Vivian

Brava is one type of fat grafting.  Fat grafting CAN be done with TE.  Surgeons here will fat graft around the TE to help repair rads damage, wait a few months, and then exchange for permanent implants.  The fat grafting can be done several times prior to the final implant.  OR it can be done at the time of exchange to fill in and help with rads damage.  I had fat grafting at time of exchange AND again at my revision.  It has done wonders on my rads side - skin is softer and more pliable, some sensation has returned around the outer edges, rads pain has lessened.  

Thanks sew! Glad to hear you've been recovering nicely. This is the 4th day post op, and I came back to work and I'm flagging a bit. Doesn't help that it's 90 degrees and I'm wearing this stinking compression thing! See my PS later today. Looking at the results so far, I feel very encouraged. I know I will lose some of the fat, but just getting to this point seemed impossible. To a casual observer my chest probably looks the same, but I actually smiled when I saw it. And I have some tiny spots where I have sensation! Wohoo!

Patricia!

Let us know how your visit with your ps went? I got a TE in June for righty and see my ps tomorrow. 

Love to you....Warrior!!!!!

Hi Girls!  

Happy July 4th!!! 

Below are some links to some of the articles out there about fat grafting.  The European one in particular I found very interesting.  They fat graft over a fulle expanded TE then wait 3 months before doing the implant exchange. 

I too had one PS recommend HBO treatment.  Only it was for a lot longer.  I have to check my notes but I think it was 4-5 weeks before TEs and 4-5 weeks after.

Hope everyone is having a great long weekend!

Lynne

http://www.ncbi.nlm.nih.gov/pubmed/24114295

http://www.europeanreview.org/wp/wp-content/upload...

http://www.clpsicpre.it/test/wp-content/uploads/20...

http://www.ncbi.nlm.nih.gov/pubmed/23158103

YAY!!!!!  I found a group talking about fat grafting!!!!!!!!! 

Hello everyone!  After two biopsies, two lumpectomies and RADS, my left breast is deformed and has shrunk - just finished RADS in mid-May but I am with all of you about FLYING and not crawling!!!!!  I know my journey has only been since September 2013 but it feels like FOREVER and I get it that I only just finished RADS in May but every day I look in the mirror and I just want my breast FIXED!  I have never had perfect, full or large breasts but they were MINE.

Which brings me to fat grafting - I REALLY like this idea - I like the idea of my own cells being moved around within my body......took me a little bit to convince my husband of that - he would prefer no further surgeries and GOD LOVE HIM, I know I do!!!! 

So.....I have a consult on August 5 with a plastic surgeon.  I have been watching videos and I know it's not pleasant - I basically held my hand over my mouth while I watched lipo and tummy tuck but I forced myself to watch!  I KNOW that I could never be a surgeon............MAMA MIA.

I am hopeful for just the grafting, do not think I will need any sort of implant.  I am praying that I do not have to wait......hope to get FG this year if possible......I WANT TO FLY! 

Lynne - thank you for sharing the links, I will check them out.