Implant revision after radiation

Firni · July 2016

I had implant reconstruction in 2009 after bilateral mastectomies. I had a recurrence in 2014 and had chemo, hecetptin and axilary dissection. Three months after I was "done", I was diagnosed with another recurrence. Chemo, herceptin and 30 rounds of rads in 2015. Now my radiated implant has contracted. It is painful, but not so much that I can't function. It is next to impossible to wear a bra comfortably or look remotely even. I saw a plastic surgeon today who told me the risk of a revision to the radiated breast was too great. And that I would have to start over with a Lat flap. He said it would be more feasible to revise the non radiated breast but even that would most likely fail and I'd still be grossly uneven. He said a lot of people live with chronic pain and as long as I can function, it would be best to just deal with the discomfort, hike up my bra on the unaffected side and get on with my life.

I refuse to believe that and I'm so frustrated. Anyone who has dealt with this please reply.

SpecialK · July 2016

So sorry this is your situation. I did not have rads but had healing issues that left my skin very fragile and similar to rads damaged skin. There are some plastic surgeons who have started to fat graft in advance of surgery for rads patients - usually several times, 6 weeks apart at a minimum. This is a newer concept. Doing thisallows the skin to have better integrity and react better to surgical revision. My PS did this twice and my skin was vastly improved. I would attempt this before I would consent to a lat flap, but I'm not sure if it would have any effect on muscle contraction or scar tissue if you have those issues in addition. Good luck!

Firni · July 2016

Thank you for your reply. The surgeon seemed mostly concerned with skin integrity and infection. He never even addressed scar tissue or muscle contraction. All he did was look at me and in a round about way, told me no. He never even touched me.

Very interesting about the fat grafting. I think I need to look for a more progressive ps

pab · July 2016

I'm so sorry to hear that you are so uncomfortable. I'm sure if your PS felt the way you did there would be absolutely no way he would last a day! It's very sad that we just 'have to live with it'. Aren't we living with enough?! There are other doctors out there. Please keep searching, you will find an understanding one! You don't need to live in discomfort.

Firni · July 2016

thank you Pab. I will look for another opinion. I'm with Kaiser so my options at this point are a bit limited. I my have to go out of the metro area. It seems like a year after rads to do any thing is typical. I have a few months to look for another PS. In the mean time my quest is to find a bra that is comfortable and will even me out a little so at least my clothes will feel right.

anki123 · July 2016

Radiation create complications and poor outcome of breast reconstruction and implant reconstruction is used after radiation.Breast tissues can be damaged.But it can be proven addition of autologous fat transfer by using patients own fat tissues.Output is appear after two stage reconstruction.have patience need not worry.

AnasNana · July 2016

Radiation broke my skin down. My scar opened up and I have a hole. I am having surgery in the morning to have the implant removed. Once the skin heals we will decide what if anything I want to do. My PS told me using your own skin works best. It stinks that not only do we have to deal with cancer but now we have to deal with the after effects.

Firni · July 2016

thank you ladies. I have discovered some new lumpiness along the scar line of the radiated breast. Onc feels it is scar tissue but will schedule a PET to be sure. I'm due for one anyway. I'll wait for the results of that before doing more. In the mean time the onc gave me the number of a bra fitter at Nordstroms that may be able to help with the weirdness of my bra fit.

I'll look for a PS that does the fat grafting, but I don't have a lot of fat. It might not even be an option for me.

The side effects of cancer treatment are so draining. After going thru chemo 3 times and rads once, I am so damaged and feel like a freak show. My hair came back in patches after taxotere in 08, the neuropathy in my feet and finger tips may never improve, my skin is trashed from allergic reaction to Taxol in '14 an now my implant has migrated toward my clavicle and is hard as a rock from rads in '15. I'm told nothing can really be done about any of this but at least I'm alive. Do they ever consider quality of life or is just life good enough for the docs? Pity party for me. The long term effects are piling up and I'm tired

macb04 · July 2016

Hi Firni, please look at my thread "TE/Implants OVER Pectoral, Can Exercise, and no Ripples ". Don't give up. I understand this is enormously discouraging. I had terrible radiation problems to my skin. My skin was just like boot leather. Thick,woody and TIGHT, TIGHT, TIGHT. Skin and muscles/ligaments were misererably, inflexably tight. I had fat grafting numerous times (5), Hyperbaric Oxygen Therapy (over 100 times) AND use Pentoxifylline and Vitamin E. My skin is nearly normal in texture/stretching and appearance. Also the constant tightness has resolved almost completely. Sounds like your PS is from the Dark Ages. Live with it ? Is he insane, or just uneducated on all the recent advances?

My reconstruction is not perfect, but considering all the problems I had, my two sides look nearly symmetrical even when nude. In a bra nearly perfect.

Firni · July 2016

macb04, thank you so much for your post! I checked out your thread and posted there. You have given me hope. Awesome vacation by the way.

The discussion board on this site has been a life saver for me. I don't know how we would recover and thrive without the input, support and information we can glean from each other here.

Thank you moderators and every woman who has posted here over the years.

Implant revision after radiation

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