Implants prior to radiation?

I have implants, although I got them 30 years ago. I am 51. I just found out about my BC a week ago, but I am considering a BMX with flap since a tummy tuck could benefit me a bit. I was told about the capsular contraction of the implants with radiation. Given the age of my implants, I think it makes sense for me to have them out anyway.

I had a one step procedure for reconstruction when I had my mastectomy, I had silicone implants put in at the same time as my mastectomy, then after healing about 6 weeks, I started rads. My plastic surgeon did this for me as I wanted to try it. It was not his first choice for recon concidering I was having rads....he always prefers a tram flap for recon after rads, but I did not want a tram flap, and I really did not want to have nothing, I mean go flat either. As NurseShark has said, my PS said if I was going to have implants then healthy skin was far better than radiated skin. He did caution me that I would definitely have contracture....the degree of severity he could not predict. He warned me over and over that women are not happy with their implants after rads, that the contracture can be severe and painful, requiring the implant to be removed, and scar tissue at that point can make recon difficult. I made my choice to roll the dice and try it.

AND.....yes, I have contracture, and shrinkage of the skin and implant. My non radiated side is perfect, soft, nice shape. My radiated side has shrunken smaller, higher up somewhat, and is harder. Plus, I can feel the implant edge in my underarm area as the implant is pulled more toward my underarm area. I had more tissue and lymph nodes removed on that side as that is my cancer side of course, and so there is more wiggle room for an implant to wiggle out of center if it is encouraged to do so by contracture. I have not had surgery to try to tweek it, although my PS originally said he could try to do so if I had problems. I would need to wait for months or even a year, as radiated skin has to heal for several months before surgery can be performed on it and the shrinkage and contracture continues for months after rads have ended. Plus, I just wanted to be done for awhile. I would say my results are not so severe that if I have to live forever as I am I am good to go. I read once someone said, "In clothes I look perky and natural. Naked, I just look perky". Yep

Someone on this website once posted after she had several recon tweeks, to resist the temptation to have surgery trying to go for the perfect boob, that sometimes you get in more trouble the more you try to fix something. Radiated skin just does not heal like we want it to.

So.....would I recommend radiating your implant side? It depends... Are you expecting the implant to be unaffected? I can almost guarentee unless you are the luckiest little bird, you will have contracture of the skin and implant, and scar tissue development. Is mine so bad that I would not do it again? Yes I would do it again, as my other recon choices were a flap or no recon. But know in advance, there will be changes to your implant. Maybe yours will be less than mine.

There are massage techniques you can do to help soften the contracture, and I HIGHLY recommend going to a lymphedema Physical Therapist after healing, as I did. She worked on my scar tissue and contracture and helped out immensely! She did a procedure called A-Stem, where she dragged a tool over my implant and scar tissue to break it up, and it really really helped soften it up. My PS did not refer me to her....I had read on this wonderful website about it and I asked for the referral myself, and said I wanted "to stay ahead of lymphedema" which was 100 percent true, I just wanted help with the contracture too. My PS should have referred me to her for my contracture alone, but I have learned from my therapist that those referrals do not come often enough, so be your own advocate.

I apologize for the long post, but I really wanted to share my experience with the hopes that it helps someone going thru it. Please let me know how your experience is and if you have any suggestions that can help me too!

I hope my post did not discourage anyone, just fyi my spouse thinks I look great, and doesnt mind one bit that the boobs do not match. My skin is healthy. I feel good.