Radiation and reconstruction

Hi Kathy,

I have just recently seen a plastics surgeon and he told me implants are not done after radiation. I don't know if that is Australia wide or just his opinion.

I am having a DIEP reconstruction instead.

Kathy

Many women have TEs put in before rads. And in fact I had implants completed before rads for a recurrence. EVerything was successful.

Hey there:

I am having reconstruction after 13 years from treatment. I had a mastectomy with radiation back then. I am having fat grafting from my thighs and then an implant placed. I was told that doing TE after radiation is difficult because of changes to skin after radiation. That is why they are doing the fat grafting first before the implant. My other options were the DIEP or the Lat muscle from the back coming round front for a flap. I too thought those surgeries sounded invasive, complicated and painful.

I now have BC on the other side as well, so I am having a mastectomy on that side with TE placed immediately. It looks like I will not have radiation on this side.

I don't know how things will turn out, but I am giving it a go.

Good luck to you

wallan.

I'm hopping in here too- because I have tissue expander surgery scheduled on April 7th and I know my chances on the radiated side are less than ideal. My surgeon seems to think I'll have a good result and that my skin looks good.

I've been through so much crap (haven't we all???) that I didn't want to start with a flap unless I had to. Since this is less invasive I figured I would give it a go first. Surgeon said lat flap if this doesn't work but he thinks I'll do fine.

Edited to add: I had looked into TE's placed before radiation during my mastectomy but the plastic surgeon I saw was a jerk. He told me he wouldn't do it then changed his mind and told my breast surgeon (not me) that he would go ahead and do it... at that point I was so overwhelmed I couldn't deal with it. So I'm almost 3 years out from radiation now

Good luck

Hey Kathy,

I also had rads and have been consideringrecon recently. I saw two ps in Perth and they both recommended double lat dorsi, but like you I'm not keen at all. I don't like the idea of potentially restricting mobility or moving muscles around..as wallan has advised I've also in the past week found out about fat grafting and then implants..which sounds amazing! Much less invasive and quicker recovery. My original ps said he wouldn't do implants only in radiated side..because of the high failure rate..he advised radiated skin needs new skin to survive, but it sounds like the fat grafting does this. I'm definitely going to pursue this in Perth..😀

I had severe Radiation Fibrosis. Then I had Fat Grafting several times. I also got Hyperbaric Oxygen Therapy to help my skin heal from surgeries. That in combination with Pentoxifylline/Vitamin E helped improve my skin texture, to where most doctors can't even tell I had radiation therapy done at all. I have a Prepectoral Implant. Look at my thread. Lots of women in the same boat. Your doctors are behind the times saying implants can't work after radiation.

TE/Implant OVER pectoral Can exercise, comfortable &NO RIPPLES!

I think this is very particular to individual surgeons. I have my expanders placed at the time of my BMX and then had radiation. But had a good friend of mine was flat for three years after BMX, then had TE's placed and then implants. We are in the US. I think a lot of success can depend on to what size you want to be. The smaller size breast you are ok with, the more likely they can stretch the radiated skin to that size. If they are trying to match one breast, that can also impact decisions.Sometimes surgeons assume you want to be the same size you are or were, so if thats not the case make sure you share that as well. I would keep trying different surgeons until you find one that is willing to discuss what you want. (I am traveling to another city for my surgery.) Good luck!

KathyNSW, yes had a unimx and originally had TE under my pectoral muscle. I was going to have a flap surgery, but changed my mind when I heard about Fat Grafting. I took out the TE, did Fat Grafting several times which really improved my skin close to normal (my skin was initially destroyed by severe rads damage, just like boot leather). I didn't keep enough fat with the Fat Grafting, but I did get from a crater to an " A Cup" Then I got a TE put OVER my Pectoral muscle, a technique otherwise know as Prepectoral Implant Reconstruction. I switched out the TE for a 495cc Mentor Anatomic Implant last spring. The grafted fat healed my skin, and in combination with the Seri Silk Scaffolding has given me almost completely normal looking skin which is soft and completely camouflages the implant. Look at my thread TE/Implant OVER pectoral Can exercise, comfortable &NO RIPPLES! Lots of women are succeeding with implants like me, even after radiation. Sorry, but your PS sounds old fashioned and rather clueless.

Hi Lizzie_S,

We want to welcome you to our community here at BCO! We hope you find the support you need. We're so sorry to hear about the difficulties you've had with your reconstruction; it sounds like you've given it careful consideration, and made the best choice for you and your lifestyle! Best of luck with the removal, we wish you a swift recovery.

The Mods

Lizzie I understand the feeling that if the plastic surgeon had told us everything that could go wrong that we would not of gone for reconstruction. My ps told me that I would not have any complications with my back and a very slim chance of healing problems.

I am dealing with an open wound and multiple infections on my radiated side that the reconstruction went necrosis and complete failure in one week. After they can get the wound to heal they will start working on the issues with my back. Sometime next year another ps will have to see how much repair that can be done to fill in the hole that will be left behind.

I had put my full trust in the ps to know what he was doing and that he had told me everything possible. That I fully regret letting him touch me. It is taking 5 doctors to attempt to fix what one ps that did not fully know or did not care did in one surgery. I get reminded of this every time I am sent to a new doctor for a different treatment.