Reconstruction after radiation info

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Smpr
Smpr Member Posts: 18
edited July 2017 in Breast Reconstruction

Some information that women should know if you are considering reconstruction after radiation. Radiation does damage not only to the skin and tissue, but also the blood vessels in and around the radiated area. This causes increased risks necrosis of tissues, infections, total failure, delayed healing, increased nerve damage and capsular contracture with implants. Delayed reconstruction also increases the chance of lymphedema especially after radiation.

I have been dealing with a failed reconstruction that has left an open wound on my chest and permanent damage.I wish that more plastic surgeons would inform women of all the complications. Most of the information that I have found out has been given to me by the wound care center doctors.

Things that can reduce the complications. Most recommended is no reconstruction. With flap procures be completed before radiation or started more than 6 months after radiation scabs have fallen of. With implants all complications that they come with on their own are increased and are more likely to happen.

My hope with posting this is that more women will be able to consider all the complications and insist on their doctors giving them all the information about the procedures. The more information women have available the less chances of complications. I don't want any other women going through what I am going through and the painful damage I will live with for the rest of my life.

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  • MommyErin
    MommyErin Member Posts: 187
    edited June 2017

    I'm so sorry you're going through this! It sounds awful!I'm currently deciding on which mastectomy and reconstruction option to go with and have a consult with a plastic surgeon tomorrow. What type of mastectomy (skin-sparing? Complete?) and reconstruction (delayed-immediate? delayed?) did you have done

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  • MinusTwo
    MinusTwo Member Posts: 16,634
    edited June 2017

    Smpr - so sorry you're dealing with these issues.

    My PS recommends tissue expanders placed at the time of BMX - before rads. I think there's just a minimum fill with installation. The rest of the fills don't take place until after rads.

    There definitely is a permanent change from rads - whether you have BMX or lumpectomy. Like my RO says, it's the gift that keeps on giving. You have to stretch every single day for the rest of your life so muscles & tendons don't curl back up.

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  • RTChris
    RTChris Member Posts: 29
    edited June 2017

    Must be so frustrating to have to deal with all those complications.

    I had my mastectomy done in February 2015 and radiation following in April and May. I was made to wait for two years before I was allowed to go ahead with reconstruction (to see how my tissues survived the radiation damage) I was also limited to the type of reconstruction I could get - luckily a DIEP flap was the best/only option for me, and would have been my first choice regardless. I did have some issues with damaged blood vessels near the axilla so during surgery the surgeon had to harvest pieces of veins to use for attaching blood supply. It took three tries to get an acceptable piece of vein, but everything is healing quite nicely now. I was back on my feet within about 3 - 4 weeks and back at full time work by 6 weeks.

    Regardless of any complications I would do it all again in a second.
    best of luck

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  • Smpr
    Smpr Member Posts: 18
    edited June 2017

    On the side that did a complete failure was a full mx with radiation on that side. On the other side the breast surgeon had left part of my cleavage. I had done a delayed reconstruction with ld flap on one side and a direct implant on the other side.

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  • macb04
    macb04 Member Posts: 1,433
    edited July 2017

    Hi Smpr, you are totally right about the damage that rads do that negatively impact reconstruction. I had 2 severe infections that added to the number of surgeries I had to do to successfully get Reconstructed. The infections occured due to the radiation fibrosis that I had. For months I had a crater from adhesions on my chest. My skin was stiff and wood like. I improved my skin by getting a number of sessions of Hyperbaric Oxygen Therapy(HBOT), Fat Grafting and Pentoxifylline. My skin improved enough I was able to finally get reconstructed with implants above my pectoral muscle (Prepectoral Implant Reconstruction). I got the HBOT at a Wound Care Center of a nearby hospital.

    What are the Wound Care Specialists offering you to help you get some degree of improvement? I hope they can help you feel better.

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  • Smpr
    Smpr Member Posts: 18
    edited July 2017

    I going to be doing hyperbaric treatment to help with the healing and infection. Right now I am going crazy trying to keep my chest dry. Using medi honey inside open areas. By the time the ps sent me to the wound care center the infection had built up enough to open my scar.

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