Does immediate breast reconstruction affect radiation?

I had reconstruction after radiation. I had a double mastectomy and was reconstructing both side. On the non-cancer side, I had no complications. On the cancer side, I handled radiation very well and I had tissue expanders placed (on both sides) about 4 months after I finished radiation. I filled 100ccs at a time (for total fill of 800ccs on each) side. When I went in for my last fill, the radiation/cancer side showed signs of infection. We tried to save the expander and I was fast tracked to replacement surgery, but we eventually had to pull the expander from the radiation/cancer side. After the radiation/cancer side healed, my plastic surgeon, who stated, when we pulled the expander, that I would have to have the procedure when they use muscle from the back of your shoulder (the name escapes me), stated I had recovered so well, that we could do fat grafting on the radiation/cancer side instead. The fat grafting worked miracles, it healed the radiation damage and 3 months later I was able to have another expander put in. All my fills went well and I am done with fills on that side and scheduled for exchange surgery in mid-May (waiting that long due to work commitments). We don't expect any issues. In hindsight, had we done fat grafting first, I don't think I would have had infection problems etc. and would not have had to have the expander pulled and then replaced.

hi, I'm not sure if this is what you were looking for…

I was diagnosed in January 2017 and was treated at Sunnybrook Toronto. I had a right mastectomy with immediate reconstruction (diep flap) in March (one surgery). Then chemo May to August and 25 rounds of Radiation in November 2017.

Like you, The medical oncologist and the radiation oncologist and the surgical oncologist were not in favour of the reconstruction. But it wasn't their body... it was mine.

I am a DD36 and I wanted to keep the other healthy breast so the plastic surgeon recommended the diep flap using my tummy fat. I'm young (36) and this was a once in a lifetime surgery and I wasn't worried about the recovery. I was warned about the radiation changing the results...

Would I do it again? Yes. It was a nine hour surgery, but I went to sleep with a breast and woke up with basically a breast without a nipple. It was larger than the healthy breast to account for radiation shrinkage. Did radiation wreck it? No. In fact it just shrunk it up, smoothed it round, and made it a better match to the size of the other one.

At almost a year later....

The pros: I can wear any shirt, I look normal in a bathing suit, it is warm to the touch and I am getting used to it more more every day. My tummy is wash board flat.

The cons:

The whole right side of my chest is totally numb...collar bone to bottom of the breast mound and half way around my ribs on the side. It will never get feeling back again. A Large band in the middle my tummy is also totally numb. No feeling what so ever.(Whatever it can't be perfect) ....

Bra shopping is impossible... the new breast is very firm, the chest wall and ribs are tender...no wires....no push ups...no padding. This is hard to describe... but the new breast will remember padding that is not completely smooth for an hour after you take your bra off...kinda like An edema dent. I am trying to be kind to her. She is loving the Ta Ta Tamer bra at lululemon.

The doctors who were not thrilled about the reconstruction have all said that my reconstruction has “had an excellent result

It sounds like they have a good plan for you. If it helps, my radiological oncologist assured me that the reconstruction would not compromise the radiation treatment. I remember she laughed at me when I asked if it would. Then she went on to say “it will pass right through everything” even a part of my right lung..... it is strange the things you find reassuring.

Remember each step is progress and there is newlight on the other side.

Wishing you a safe surgery and a comfortable recovery.