has anyone had success with implants after radiation?

hello I have a skin saving expander and have had radiation and my implant survived it all and now rather than a tummy or back op I have decided to have the port expander replaced with a silicone implant and an uplift to the other breast X hope this helps

I had 26 sessions of radiation with a tissue expander, The plastic surgeon over expanded that breast in case the skin was damaged he would have extra skin. I used the expensive cream one r.o. Suggested. I think it. Was called. Miderma. I had to wait 6 months after radiation for the exchange. He said my skin had to cool down even though i never burned. I had the exchange last week. It can be done. Hugs

Hi Jneff,

Welcome to the BCO community! We do hope you get some responses to your post here soon.

While you wait, you may find some of the information in our main content useful in helping you make the best decision for you.

Implant Reconstruction

As always, we also advise you to talk with your doctor and or your surgeon about this procedure.

Best wishes,

The Mods.

Thank you for your response. I have done the same reseach and have read the success rate isn't great. I have had no issues with the tissue expanders, but I did get them before radiation. The flap surgury is just not an option for me. I am leaning toward just going flat because I have a family to support and I don't have time to deal with complications.

Hello all,

I did have implants after radiation 17 years ago. I had a TE placed at the time of my mastectomy at the age of 39. I had no problems with healing through A/C Taxol followed by radiation. In fact, my plastic surgeon said he would not give me implants after radiation, but luckily his partner agreed to do it, and I have never had a problem with them. I did wait about 6 months to a year after radiation before replacing the TE with silicon implants. The skin over my implant is very thin, cold, tight and nearly numb, and they aren't perfect, but I am happy to have them covering my bony chest. In the end, I don't know if I would have gotten a better result with a flap? I didn't have enough extra flesh to move around and, at that time, I didn't want to be carved up any more.

HI Jnff! Just wanted to share my story with you. Had Bil. Mastectomy with axillary node dissection of left side Nov. 2016. Completed 33 radiation tx on 3/4/17. Had my expanders exchanged to implants on 3/21/17. Post op recovery went well, now back to yoga! My radiated breast is a bit smaller, but cant tell with a bra on. Also, I am 63 and feel great!

jneff

I had a BMX, TE, Chemo & 28 rounds of radiation. I finished my radiation 12/7/16 and Im happy to say I had my silicone implant exchange on 3/8/17. I am meeting with a different PS for nip reconstruction, it can definitely be done it really depends on your skin and how it holds up. Mine did really well so my surgeon was comfortable doing the exchange earlier, other surgeons wait. One thing that has helped me is to do my stretches daily in the shower. There are a few women Molly 50 and Leslineva who also had silicone implants/rads. Look on the exchange thread and PM them with questions. Leslienva just had nip recon and I reached out to her with questions, she was awesome. Best of luck to you.

i didn't see anyone besides me commenting on Fat Grafting. It really, really helps rehabilitate radiated skin. It improves the microvascular circulation, which is the defining criteria in how well radiated skin is able to tolerate implants. Using Dopler Studies, they have been able to show improved blood flow after getting fat grafting in radiated skin.

macb04 - you don't have any articles or studies about this do you? I've been talking with my ps about fat grafting, would love all the information I can get to help decide.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4461711/

Science has yet to identify any association between autologous fat grafting and increased breast cancer recurrence (37-40). Furthermore, current studies have reported excellent aesthetic outcomes, a high degree of patient and surgeon satisfaction and overall a low rate of complications (38,41). More than just filling contour defects, autologous fat grafting fundamentally changes the quality of the overlying skin envelope especially in setting of radiation (42). Pre-clinical studies have shown reversal of radiation-induced dermal fibrosis and hypovascularity (43). Autologous fat grafting has proven to be a valued tool in breast reconstruction, which has revolutionized surgeons' abilities to camouflage the prosthetic devices allowing for reconstruction of a natural breast.

Radiation therapy has become a mainstay in breast cancer treatment with more women being offer radiation treatment as studies have proven a survival benefit (44,45). This poses a challenge for reconstructive surgeons. Historically, prosthetic-based reconstruction was discouraged in the setting of post-mastectomy radiation due to the high rate of wound healing problems, implant malposition, capsular contracture, infection, extrusion of implants, and poor aesthetic outcome (46,47). However, with the adjuvant tools available including ADMs, anatomic breast implants, and fat grafting, successful prosthetic based reconstructions are now possible (48-51).

FLBuckeye - you have posted this same message on 3 or 4 threads. Will you please go to My Profile and enter your diagnosis & treatment specifications so we will be able to compare with our own progress?

Thank you.

Hi meg2016, and all. There are studies about fat grafting improving the outcomes of Implant Reconstruction after Radiation. Here is just one of many studies about Fat Grafting.

Adipose-tissue grafting to the post-mastectomy irradiated chest wall: Preparing the ground for implant reconstruction - L'Institut du Sein

https://www.google.com/url?sa=t&source=web&rct=j&url=http://www.idsein.fr/img/pdfs/3-376.pdf&ved=0ahUKEwiVkaWL2uTUAhUs6YMKHZI5Auw4ChAWCCkwBQ&usg=AFQjCNHceUyiYO5HTPPSkl_shB_KRlSk5Q

Fat Grafting and Breast Reconstruction with Implant: Another Option for Irradiated Breast Cancer Patients

Salgarello, Marzia M.D.; Visconti, Giuseppe M.D.; Barone-Adesi, Liliana M.D.

doi: 10.1097/PRS.0b013e31822b6619

Breast: Original Articles

• Abstract
• Author Information

Background: In postmastectomy radiated patients, autologous tissue reconstruction is preferred over implant reconstruction, because the latter is associated with a higher rate of postoperative complications. Autologous tissue reconstruction, however, is not always feasible and is sometimes refused by the patient. A challenge also arises in breast-conserving surgery patients seeking breast augmentation with an implant. In this article, the authors present a further reconstructive option for irradiated breast cancer patients consisting of fat grafting followed by implant placement.

Methods: The authors retrospectively reviewed 16 cases of irradiated breasts treated with fat grafting and subsequent alloplastic reconstruction/breast augmentation. The evaluation methods were clinical and photography-based assessments. The BREAST-Q was used to quantify patient satisfaction.

Results: Sixteen patients, with a pretreatment Late Effects on Normal Tissues–Subjective, Objective, Management, Analytic (LENT-SOMA) score of 1 or 2, underwent two to three fat grafts to achieve a LENT-SOMA score of 0. The placement of the breast implant had been performed in a separate stage at least 3 months after the last grafting session. The average follow-up was 15 months. Reconstructive outcomes were graded from excellent to good in 93.7 percent of patients. Patient satisfaction was marked as high to very high. There were no short-term complications. A Baker grade 1 capsule contracture was found in all patients.

Conclusions: The authors' experience shows that breast fat grafting followed by implant placement may represent a feasible reconstructive option in highly selected patients with irradiated breasts. Fat grafting seems to reduce radiation-induced complications in implants. Larger studies with a longer follow-up are needed.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.

Mimi- are you referring to find a ps to do autologous tissue recon? There are several centers that do that type of recon across the nation. The one with the most experience, has pioneered the latest techniques, works on you as a whole during stage 2 (focusing on all surgical areas and the outcome from stage 1 vs just focusing on your breasts), has the lowest failure and infection rate nationally is the center for breast reconstruction surgery in New Orleans. Women travel from literally all over the world to have them do their surgery. Comparing their before and after pics to other centers' pics is no contest. There are many women on this board who are very happy with their results including me. heres their website link: www.breastcenter.com

Mimi - I believe you'll have to look around to find a PS who is truly experienced in fat grafting.

Thank you very much for the helpful information!