Reconstruction after RADIATION

Hi BayouBabe and others who've had fat grafting! I'm rather new to this forum but am looking for women who've had fat grafting prior to their exchange surgery. My PS won't do it before putting in my implants but I read new research that it is helpful if you've had radiation.

Since I want to reduce future complications (i.e. capsular contracture, etc.) I'd like to hear women's opinion on fat grafting before their implant surgery, and if you found it has helped with tightness caused by radiation and if you had no complications post-surgery.

Would love to hear your stories! Please private email me with names of doctors so I can find one hopefully close to me in the Kansas City area. Many thanks!!

smlvr- I had infections during the fills and had to have my left TE removed (radiated side).  So, next we tried FG.  After the first FG, I got another infection.  But, after the second FG all was good.  The PS and I think the first FG greatly improved the integrity of the skin on the left.  I am a big fan of the FG!!!!!

I am due for my exchange on Oct 17-at which time the right will be an exchange with a lift and the left will be direct to a VERY SMALL implant.  I don't want to try TE's again.  We're hoping this works- no guarantees!!!  I am ok with asymmetry.  You can PM me-I also live in NY

Babs

I had 350 on rt and down to 0 on left. But FG gave me some upper pole fullness on the left so in clothes with a prosthesis I look " normal". No longer concave.  We'll see what happens with the exchange  and mastopexy on the rt and direct to a very small implant on the left. Fingers crossed!!!!!

Babs

I had 2 FG months before TE because research is showing good evidence that the stem cells from the fat improves integrity of radiated skin and tissue on a cellular level.  I had my last FG 4 months prior to TE and my last fill is this next Friday.  At my last appointment for a fill my PS visually he could not tell the radiated skin from the non-radiated skin.  If I remember correctly I had 32 rad treatments (30 + 2 boosts).  That was just last year and I thought I would remember everything about the whole chemo / rads thing and in some ways that seems like so long ago.  That's a good thing!!! i hope to have my exchange in about 6 weeks.  About 15 months ago I was so incredibly depressed with everyone  telling me statistically the chances of a successful recon without flaps was pretty small.  Needless to say, I'm a HUGE fat graft fan.  

Keep in mind there are limits to how much can be expanded on radiated skin.  Prior to BC I was a D-DD.  I will be grateful for a small C now.  I'm at 360 cc now and my PS thinks going too much bigger will be pushing the envelope.  

In my opinion and experience FG well in advance of expander surgery is the BOMB.  Takes a lot of patience and being tolerable of being uncomfortable (sometimes even pretty significant pain) and physical restrictions for several months.  You have to decide for yourself if it's worth it or not.  Soooo worth it for me!  

Good luck figuring out if the process is a good fit for you or not.  

can you ask your surgeon for the research info on fat cells helping micro tumours to grow please?

So happy to hear this Patricia! Yes keep us posted. Don't be nervous, just think how far you have come.

You are a Warrior!!!!!!!

HELP ladies!!!! I had BMX on August 1, with TE's placed at that time. I was originally told no chemo or radiation. I have been having fills of the TE & am up to 500 cc's. My plastic surgeon and I have been VERY happy with the expansion & they look great. Well, my MO decided I should do Taxol/Hereptin which would put my exchange on hold. That sucked, but I was fine with it. I knew after chemo, I would be getting my new boobies!

Well...fast forward to last Tuesday when all of the sudden they are discussing radiation. It had been ruled out weeks & weeks ago. I am seeking a second opinion next week. I have already met with my plastic surgeon who is very upset as this changes everything. In her words, radiated tissue is the devil in her line of work. She did mention fat grafting & some other options, but in the end she can't guarantee that my body will be able to take an implant even though I'm basically done with expansion. Has anyone gone through this? I am thin & was told I would not be a candidate for any type of flap procedure. Implants were my only option.  I am only 39, spend a lot of time at the pool with my kids & honestly my cosmetic outcome is very important to me.

Miscraw - check into overfilling just the side getting rads prior to starting.  This allows for some hardening/shrinkage that rads can cause.  It will help insure a more "even set" when you have your final exchange surgery.

I am 48 years old and long past surgery and radiation.  I had my last rads in April of 2007.  I had two lumps removed that left me with a partial left breast that I disguise with a prothestic.  I decided last summer I was tired of the prosthetic and visited the PS only to be told the best he could do is reduce the unaltered breast to be the approximate size of the other because of the tissue left behind from radiation.  I didn't like that answer and asked for a second opinion.  The next doctor suggested that he could do a transflap, which is extensive or reduce the unaltered as the first doctor said.  I left feeling very dejected and wondering if I had been right to believe that I should wait to have the breast constructed again.  I would love to travel away from my tiny little area to see a doctor who specializes in breast cancer reconstruction and not just cosmetic surgery, but I cannot afford to do so.  

I thought I made a really well informed decision to put off reconstruction and focus on SURVIVING, but now I wonder if I really did have the strength to do both and I should have had more faith in myself.

Hi Miscraw- see if they will do your exchange to a permanent implant ASAP and let it heal for a couple of weeks before you start radiation. You should be filled enough by now to accomodate the exchange/implant. Talk to your plastic surgeon- he or she will be your best advocate. 

Otherwise you might have those expanders for a year while your skin heals up from radiation and that is way too long.

You have the right to delay radiation for a month. it is your choice.

I did it that way and am thrilled with the results- just got my final revision and lift on the other side. All good.

GOOD LUCK!!!

Hi dishlady, and welcome to this wonderful community! We're sorry you have to go through all this, but glad you found us and decided to share your story with everybody here. Please keep us posted on how everything is going. 

Wishing you all the best with your recovery,

The Mods

dishlady - be sure to check into the fat grafting BEFORE your exchange surgery.  Many of us rads girls swear by the results it brings to healing rads tissues.  Good luck and hope you find relief from the tightness soon.  TE are definitely not comfortable.  Hang in there!

dishlady - my PS did the fat grafting at the same time as my exchange.  However, I know from my support group that other PS like to do it first, then do exchange surgery months later.  I had fat grafting twice - once at exchange, second during a revision.  Both sides had fat grafted (this also helps fill in slope above implants, surrounds implants with your own fat, and repairs rads damage.). Very glad I had it done!  My rads side is now almost indistinguishable from my other side.  Makes me happy and makes me smile when I pass a mirror before or after a shower!

TE sit under your pec muscles.  So the fat grafts are placed under your skin, over the muscle.  I think this is usually done before exchange if you have problems with the integrity of your skin after rads or have healing issues.  The hope is that the stem cells repair the damage, making the exchange go easier with fewer complications.