CanNOT Reconstruct after Double Mastectomy and Radiation?!

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Janice12
Janice12 Member Posts: 4
edited October 2017 in Breast Reconstruction

Hi all,

I am posting my best friend, she went to see her plastic surgeon yesterday and was told that they cannot reconstruct because of her skin after radiation is apparently “really bad". The doctor said that my friend won't heal. (My friend had a double mastectomy last August, 2016. She had radiation for 10 weeks and that ended four months ago.)

What we don't understand is, she currently has expanders in place now for “C" cup. They have to pull out the expanders eventually and there will be room for breasts. My friend doesn't care what size, even a small “A" cup is great for her. None of her other doctors ever mentioned any issues recently and they have examined her. Plus, my friend JUST saw this plastic surgeon about a month ago for a follow-up and everything was fine! (I want her to see her oncology doctor for a referral to a new plastic surgeon, but am afraid to get her hopes up if they cannot reconstruct, so I wanted to post here first..)

My best friend is completely devastated, any suggestions are very welcome.

PS. Thank you in advance. I so admire all of the struggles you ladies have been through, you are some strong woman, going through this B.C. journey.


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  • KBeee
    KBeee Member Posts: 5,109
    edited September 2017

    She should get multiple opinions. She may need to allow more time for a better evaluation. The concern is with healing. She should get an opinion from a university medical center who may have more options for her.

    I was told by my PS that I cannot have a revision because of how badly I burned. (I had implants before radiation and that side is now rock hard and 2 inches higher than the other). When the time comes that I eventually need new implants, I plan to get multiple opinions at Mayo and/or a university

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  • Janice12
    Janice12 Member Posts: 4
    edited September 2017

    THANK YOU so much for replying. I passed along your message. I wish you the very best on your future recon.

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  • annieb4
    annieb4 Member Posts: 106
    edited September 2017

    Janice,

    I, too, had a double mastectomy and implants. Was then informed because my skin was so damaged by radiation and very thin, implants would not work. I ended up going to Mayo in Rochester and having a Deip flap procedure, This is taking a part of the belly and creating two breasts. Am quite happy with the results. I do not have very big breasts because I am not a very big person and there was not much there to use. I actually had to put on 20 lbs. So maybe that may be an option for her. It was a lot to recover from, but have no worries now about implants. Just make sure to use a qualified surgeon.

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  • annieb4
    annieb4 Member Posts: 106
    edited September 2017

    I meant to say I had expanders put in after the mastectomy, not implants. There are also a few other places on the body they can take fat from to make breasts.

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  • Janice12
    Janice12 Member Posts: 4
    edited September 2017

    Thank you! Geez…It sounds like you went through a lot. I respect you for getting through all that. Thank you for lifting her spirits by sharing your similar experience.

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  • Lily55
    Lily55 Member Posts: 3,534
    edited September 2017

    It is very early days yet, surgeons in Europe often insist on waiting a year after radiation before they will reconstruct due to skin damage.  So it is too early to be told she cannot have reconstruction in my humble opinión.  She can improve the condition of the skin by using cannabis oil cream, or castor oil (beware this stains), having a good diet and ensuring she has enough Omega 3, B12 and Magnesium, and drinking a lot of wáter..........  

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  • Janice12
    Janice12 Member Posts: 4
    edited September 2017

    Hi Lily,

    That’s what we thought too, way too early to tell! Thank you so much. Thank you so much for the wonderful and very helpful advice. Ps. the picture of your cat is so cute!

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  • Meow13
    Meow13 Member Posts: 4,859
    edited September 2017

    I consulted with several plastic surgeons I had one tell me she would not work with radiated skin period. The others would. I didn't require radiation I had a DIEP left side came out excellent the match was very good.

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  • sbelizabeth
    sbelizabeth Member Posts: 2,889
    edited September 2017

    Janice12, your friend needs to talk to another plastic surgeon. Someone with lots of experience with breast reconstruction, who also has experience with "flap" procedures.

    I had a DIEP flap procedure and am very happy with my results. I needed to wait six months after radiation treatments to let the skin effects settle down.

    Reconstruction with expanders and implants can be problematic for those who have had extensive radiation treatments, since the skin becomes thin, fragile, and prone to infection. But there are many, many more options. Fat can be taken from the abdomen, thigh, butt, or back, and shaped into a "breast."

    There are several centers in the United States that excel at challenging reconstruction. The Center for Restorative Breast Surgery: https://www.breastcenter.com/ comes well recommended, and they work with women around the world.

    I didn't have my own surgery there but I know women who did.

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  • CarolinaMommy
    CarolinaMommy Member Posts: 18
    edited September 2017

    I'm hardly adding to the convo, but I remember my plastic surgeon (totally awesome!) would use radiated skin, but that many didn't. He is for natural reconstruction, which, as others have said, uses ab (or other) tissue (not muscle, just tissue) to make new breasts and can use skin from elsewhere also as needed. It sounds weird, but I'm not patchy or anything, and it let me lipo my thighs to harvest the fat- hooray!

    It's a long process of multiple surgeries, and some seriously icky recoveries, but if you can marathon it to the end, then they just feel like breasts, but with so little breast tissue that you don't even need mammograms anymore, for the rest of your life. Just boobs again. I just got mine tattooed and am feelin pretty savvy.

    I hope she will not worry overmuch- there will be a way to reclaim her body! One doc saying no maybe leads you down a different, better path, that works for you/her

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  • SpecialK
    SpecialK Member Posts: 16,486
    edited September 2017

    Something else to consider is having fat grafts to the radiated skin prior to any other type of surgical procedure. This is a process of lipo, then the small amounts of fat are injected around the skin, and this process is repeated over a period of time. I did not have radiation but had extensive necrosis and skin healing issues that mimicked what happens to radiated skin. Fat grafting made all the difference for me, I was able to exchange and complete implant recon. Here is a link to some information about this - it can restore skin integrity to the point where implant exchange can be accomplished. Since she already has stretched the skin with expanders this may be a solution if she wishes to continue with implants, or is not a candidate for a flap procedure.

    https://community.breastcancer.org/forum/70/topics/744891?page=1

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  • SugarCakes
    SugarCakes Member Posts: 353
    edited October 2017

    I had BMX with immediate expanders. Then had exchange for implants and THEN had radiation. With implants there are two very different sides of PS; one for implants before radiation and one for implants after radiation. Wait... there iIS that that 3rd side of PS that want NOTHING to do with radiation reconstructions! Obviously you don’t want one of those PS. Find another one!

    Question: was it not a PS that put in the expanders???

    Anyway, it’s been two years for me and I’m wanting improvement. Some would be totally happy with what I have. I’m not. Radiation side is tight, hard, sits higher... I’m looking at a Lat Dorsi flap with a new PS in January. I’m excited! It’s this flap for me bc I don’t have enough bodyfat for the other flap options.

    Find a PS that will reconstruct after radiation. Plenty do. Where are you located?

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