Breast Cancer with Implants

I also have implants (16 yrs ago) my PS is removing mine and putting in TE and then eventually  the new implants. He was surprised that I never had them switched out (supposedly you are suppose to every 7-12 yrs) My old PS told me 10-15 yrs. One good thing my new PS said is that since I have BC all future swaps of implants are covered by the insurance because it is considered reconstruction not cosmetic anymore.

Regarding radiation and implants he did mention that it can be problematic having radiation with implants/te because of how the skin and implants react to radiation (skin thickening/harder to stretch, shrinking of the implants), but he said if I had to do radiation and the problems arise we would work around it, such as possibly having to remove the implants/te and do it again afterwards. TopQuality, your concerns are definitely something your PS should be able to answer on how they would approach your reconstruction. As Homemom said, it will all work out.

With today's implants you do NOT need to swap out at any certain time (7-10 years, 10-15 years). You only need to swap out if there is an issue with the implant or you choose to swap for other reasons (size, etc). Today's silicone implants are very cohesive or truly cohesive and do not have the same concerns with leaking like old implants did. The 10 years thing often comes up because many manufacturers offer 10-year warranties, some patients like to switch out to renew warranty term...as a reconstruction patient you are "covered" anyway if your implant does need replacement. And of course, the PS gets paid for doing another surgery to replace. Both PS's I consulted including my own PS were very, very clear there is no need to replace implants according to some pre-determined schedule and even cautioned against it. 

In my opinion, and you should try and limit further unnecessary surgeries as every surgery increases chance of complications - especially as a reconstruction patient who is at risk of needing more revisions in the first place. Be careful about switching implants just because you have been told you should do so every 7-15 years, when there is no other reasons to do so except for that. Obviously if you need surgery to correct an issue, or as you want to have a bigger or smaller implant, that is a different situation.

OP...the concerns are that radiation is difficult on the tissues, you increase risk of capsular contracture when you have implants in a radiated breast as well, whether implant is in there before and after. Also, if your implants are sub-glandular, they will be in the way of treatment. That is not to say you definitely cannot get an implant again after radiation (and yes, they may indeed want to put a tissue expander in there) but there are contradictions to think about. 

Also, if you were to choose an MX and reconstruction, I don't want you to think it just means you definitely get "new and improved" breasts. You can indeed get a very good cosmetic result, but that is not a guarantee, they still will differ for natural or augmented breasts even if great cosmetically, there are risks of rippling, low projection, and there are higher risks of complications, and you do NOT keep your pre-existing sensation, may have continued and ongoing pain or nerve damage, and so on. Some women are very happy with their reconstructed breasts, but others aren't, so you really need to weigh the decision that is right for you if you do have option of either LX or MX. After radiation, some women also choose to go with a tissue flap either with or without an implant to decrease risks of capsular contracture, tissue necrosis, etc that exist with Implant reconstruction on a radiated breast.

This post is about 6 weeks old, but saw it when looking for something related to a new situation.

I had silicone implants about 7 years ago, but they are under the muscle.  I had the PS look at them prior to radiation as I kept reading you have a complication more often than not.  He said it would be an exception and told me all the things he could do to fix them.  I'm almost 3 weeks out of 7 weeks of radiation and they aren't perfect anymore, but they don't look horrible either.  He saw them about a week after radiation and said the radiated side got a lift and it did look like that.  Said he could lift the other side.  I see him again in 3 weeks.

I do feel the radiated side has shrunk, it is flatter, and will probably do something, but my breast surgeon said not to do anything for a year as radiation continues to cause changes for up to a year.  For about two weeks after radiation was complete I was still getting swollen on the radiated side.  That doesn't seem to be happening anymore so they are starting to make the normal changes that would occur.

If your implants are not under the muscle that would be the reason for taking them out during/prior to surgery.  And as mentioned we are all eligible for reconstruction once we have undergone treatment/surgery for BC.  Good Luck!

I had implants. They were the reason I chose a bilateral mastectomy. Rads causes skin changes which can make breast augmentation and reconstruction very difficult later on. I sought the advice of two plastic surgeons, just in case. I did not like the idea that Rads would cause skin changes. I currently have my expanders in, and they look reasonably good

I know the final anatomically formed gummy bear implants will make the affected breast appear much smoother.

I made the choice early on to not have Rads even if it was recommended, as an FYI.

Hi! I have implants under the muscle (silicone). Have had them for 6 years, and many Dr's will tell you that, rads and implants don't do well together. I underwent 35 rad treatments, and if anything the radiated breast now looks better, it got a lift. It has been 6 months and I'm waiting to see what happens. As a whole they are not as perfect as they were, and one day I may see what I can do but my radiated breast looks pretty good!

Cath57, yes and I have my first post rad mammo tomorrow (6 months) there is an area that really bothers me, so am interested to see what is going on in that one area. Mine was at at 3:00 position though so was on the side. My whole breast, and side chest wall were radiated. Plus it was close to the skin, so I had a bolus the entire time including during the 10 boosts a new one was made.
I did not deal with capsular contraction though and the PS said more often than not you do have issues. They did a great job and of course they looked much better prior to all this, well they looked really good. They don't look terrible now....I have battle scars.

Thanks Cath57. Mammo not so well. I'm sure everything will be fine, but near my scar there appears to be a cyst, but even with U/S Dr wasn't positive, so first they will try and aspirate, and depending on what happens biopsy. I have faith it is nothing major, it has only be 6 months post Rad, what is hard is I just want to get on with my life and every time I turn around, it is the gift that keeps on giving.

hi, I am not sure if my history ll help, I had implants when I was diagnosed with bc. I had chemo then surgery they took the implants and replaced them with expanders,then I had 6 weeks of rad with the expanders then had to wait 6 months with the expander in order to have an exchange to implants. Anyway the rad side once it was radiated it somehow heal very fast and yes I had muscle contraction so another surgery on August to change implants and release the internal scaring. So yes there is a lot of Se with rad and implants but over all I agree with the others the rad breast looks way better at the long run.

Have a wonderful xmast all of you

thanks, just keep positive it does gets better, it's a very slow healing process but in two years. Two years it took me to heal and be able to function somewhat normal again

Take care

;( in deed

Cath57, hope you are ok just wanted to say hi, well I am not 100 % happy with my new implants lol as you may know it just never gets to what we once had. I have no fat around mine so I feel the plastic literally when I touch them and even when I look at them I see the lines its just not what I hope for. I must accept them now since I am quite sure this is what I will end up with. My right breast where I had rad is worse the internal scar tissues are hard and visible plus the breast turns to the side significantly. Hope you are having better luck.

Take care keep in touch sending hugs to all of you out there whom have implants.

Hi, well me too i had a NSBMX and yes i have been told that fat grafting can help but in Canada where i live Dr. do not offer it. Its like i need to be greatful they save my life and that i shoud be happy with what ever. Oh yes the " do not worry about appearance right now speech " in my case i had to fight to save my skin and nipples. This doctors here in Canada are the worse. All they care is about the chemo and the Rad they will use on you they have no interest about the way you will feel after it is all done. I hope you have better luck i am ok not 100% satisfied but ok since i manage to look great on cloth. I am very shy now so i will stay single for a wile. It is not a body i am proud to show any one without the cloth. The radiation really damage the tissues and it can take more than one surgery t get close to where we were before this nightmare came. Again everybody is different hope your body reacts well. Take care and keep in touch. this August it will be a year since my last surgery in which i had new implants and pocket correction. in one year already lost balance again and things are again not looking great. We shall see what the PS says when i see him next.

I was diagnosed a couple of weeks ago, and next Wed. have to make the decision on Mastectomy or Lumpectomy. I've had my saline implants that are under the muscle for 15 years now and am fretting about the possibility that it will be deformed. The more information I get, it seems the more on the fence I am on what to do. I'm more afraid of making the wrong decision than I am the cancer today. I read on this forum that they will replace both implants and insurance covers that.

How long between the initial surgery and radiation treatments do you have to wait to get them replaced?

Does anyone have any advice to offer on mastectomy versus lumpectomy? Thanks!

hi I just want to tell you.research about Nipple sparing mastectomy if you are going for the mastectomy try to save your skin and nipples I did and it was the best decision I made .Now the rad side gives me a bit of trouble bit my breast look normal and I am happy I kept my body as normal as possible.

Please research as much as u can and do not let the ps make decisions for you.

Good luck