Radiation before or after reconstruction?

I love my PS and that's his plan for me I'll do exchange before rads. Some people have been surprised by that but my guy is good and I trust his judgement. Also RO says damage doesn't happen like it used too as technology has improved a lot. If I were you I'd seek a second opinion from RO.

Best wishes

I think it depends on each case for me I had skin involvement also so that has an impact. I would ask if both breast would be radiated in my case it would not. The main issue seems to be shrinking and Harding of the cancer side breast. Ask what their experience has been with both implants and TE's . Also your skin pigmentation has an impact. I'm dark year round ( native and white ) so I was told my skin should do better than someone who is fair skinned.

It is important all your doctors agree on the plan - whatever plan you eventually choose. Remember that radiation might be targeted to different spots depending on the specifics of your particular case, so in my opinion your RO has the last word how (s)he wants to do that. If you don't like or don't understand what your RO is saying seek a second opinion before it's too late.

Radiation can be done on expanders and on permanent implants too. Radiation does not impact expanders or implants but it does impact the tissues and no matter how good your RO and PS are, radiated breast will be slightly impacted. In the past, they recommended doing radiation first, then waiting at least six months or more before doing the exchange surgery. Reason: tissues don't heal well after radiation, so the odds of complications after the exchange surgery are high. Nowadays, some institutions and plastic surgeons are open or even prefer doing the exchange surgery first and radiating when permanent mplants are already in.

When faced with the same decision about four years ago, I decided on having the exchange surgery first and radiate with the permanent implant in. My medical oncologist was initially against it because she was afraid my rads could be delayed if any complications arose from the exchange surgery but my PS and RO managed to convince her. Everything worked out pretty well and 3.5 years later I am very happy with the looks and everything else. Just remember, this is not going to look perfect as the radiated breast is usually a little perkier than the other one. In my case, a small difference in shape can only be noticed when I am naked.

Best to all.

All the dates are in my profile below, rads started 4.5 weeks after the exchange surgery and 8.5 weeks after the last chemo. Studies have shown radiation is most effective if started no later than nine weeks after chemo, it's effectiveness starts to decline from week nine but it is considered acceptable to start radiation up to week 12 post chemo.

Thanks for posting to ask, and thanks to others for sharing their experience. I got a call today that RO talked with MO and PS and they want to do my exchange surgery before rads. This would put rads start date at 5 weeks PFC (which is within clinical guidelines).

I had initially planned implant surgery, then switched to a DIEP flap when I found out I needed radiation and heard about the high potential failure rates. Now they want to do the exchange surgery in between, mostly because the button on my expander poses an issue with proton therapy, which is what I'm currently scheduled to have (reduced risk of radiation exposure to the heart).

As a constant planner, these changes are throwing me for a loop.