Trouble with reconstruction after radiation

bhansen66 · August 2018

Hello, I finished my radiation on March 6th, and did not really have any bad side effects other then some peeling up on the lymph node area, my breast area did get very red but no blistering or peeling. About halfway thru the treatments my expander collapsed, but was still in tact and would hold some fluid when we did resume fills. I opted to not replace but to proceed with reconstruction. On 6-29-18 I had reconstruction with implants the cohesive gel kind. Everything was going great when after 6 weeks my radiated side incision came open about 4 inches across the front. ugh...Had to go to the ER to get stitches and then back in surgery on Monday to remove the implant and clean everything out, no infection only inflammatory tissue? My PS says at least 2 months before we can put the expander back in and then a few months after that replacing the expander with another implant?? So just wanted to know if anyone else had any issues that far out from reconstruction and any ideas on doing anything different like a flap surgery instead of implants? I am a very active person with my job as a vet tech and I also have a small farm, so I am outside and busy all the time. So not sure which option I should do, but considering all of them at this point. thank you

Skier-girl · October 2018

Hey!! I feel your pain. Here is my issue:

- Mastectomy with TE April 13th 2018

- Radiation August 2018

- Infection in TE Sept

- Had surgery to pull out the TE and flush out the infection. Sept 13th

Implant was put in (but it is radiated skin and is not healing!!)

- Hoping radiated skin heals. I am not sure what will happen if the implant has to come out for a few months??

I am trying to eat right, am going to hyperbaric chamber (to help with healing). I am so upset!!

I too am super active for my work and am scared about doing a flap surgery, etc.

If any of you have had surgery on radiated skin... please let me know if it was successful and what you did to make it!!

bhansen66 · October 2018

Hi, well I am still waiting on my next surgery, they removed everything from me after my surgery site opened up in August, after about 8 weeks it has finally stopped getting fluid out and is healed but unfortunately It looks like I have to start over with a new expander and then the DIEP surgery after that. MY TE expander collapsed when I went thru the radiation and we opted to not replace and just proceed with the reconstruction, but I am thinking I should have replaced it then but just didn't want to do another surgery but now it looks like I will be having 2 more, My expander never did fully expand after the collapse so my skin never really got the chance to slowly stretch out? So I am not sure if that was the problem but we will see, hope all goes well with yours

CENOK2017 · October 2018

Have any of you had radiation, waited several months, and then had tissue expanders put in? Just wondering because that is my plan at this time

bhansen66 · October 2018

I had my expanders in during radiation. The radiation is what caused the collapse, sigh...but some doctors do different things, maybe doing it the way you are doing it would be better? I hope everything goes well, are you doing implants after the expanders? Or a flap surgery?

Cpeachymom · October 2018

cenok- I finished rads (33) last November and just had my TE placed last week. My PS prefers to do delayed reconstruction after rads when everything settles. I can tell you that rads tightened everything on that side up dramatically, but so far I’m healing well. I would at least ask about fat grafting Before TEs because several people have said it really helps soften up the rads skin. (I asked but he didn’t agree to it)

bhansen66 · January 2019

Just wanted to give an update, finally in December I was healed up enough to have the TE replaced and basically start over. He was able to go in and remove the previous scars and some radiated tissue and it does look good. So most likely in a few months I will have the implant put in. That will be one year from when I had radiation so hopefully this will go better. How is everyone doing?

Houston2016 · January 2019

Hello,

I had last rads in 01312017 I still have TE in my PS recommend me to do Diep flap because the rads skin will not hold the implants well. I haven't decided yet because DIEP is such extensive surgery. My problem is the left radiated skin side start to have rash it's not itchy or painful. It started late in December 2018 then Tuesday this week the PS did biopsy for IBC, Varicella, etc.. has anyone out there with rash on your radiated skin? Thanks.

kellymoye · January 2019

I had a lumpectomy and radiation, finishing in June of 2017. In October 2018, I had a double mastectomy after a genetic test came back indicating I was at risk for a second breast cancer. I am very thin, and my radiated breast had healed so well, that my PS thought it was safe to put in expanders/implants without using autologous tissue. I too had read up on the DIEP and it looked like such an extensive surgery that I was glad to avoid it. Plus, I already had saline implants from an augmentation I had done 20 years ago and that surgery was a piece of cake. Unfortunately, my radiated breast responded to the expander by becoming very inflamed and developed a seroma (thought it was infected but it was not) and the expander actually started to extrude thru the incision line so I had to have it urgently removed. As soon as the expander came out, my entire lower breast collapsed into a mess of fibrosis. I now have to wait months and have a DIEP after all, with an implant on the healthy breast. Or I can decide if I can just live like this. I wish now I could just be flat but with all the fibrosis I fear that ship has sailed. Let me be a cautionary tale to all who have had radiation ---radiation and implants do not mix!

Trouble with reconstruction after radiation

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