direct implant after failed implant?

Hi, I'm not in the exact same position. I had an infection, but no rads.

I got a new TE in November, and I'm slowly filling before getting the new implant.

My neighbor had rads and an infection in her direct implant. After a year of battling the infection, she got a DIEP surgery and is happy.

This doesn't answer your question, but it's all I've got!

bunny - I did not lose an expander, and later an implant, to infection, but rather had skin issues very similar to what can happen with radiated skin. My skin tore under a necrotic area with the expander, which ruptured through the skin and had to be addressed in an emergency surgery. I stayed flat on that side for the seven months during chemotherpay, then was able to have surgery to place another expander, slowly fill, then exchange to a silicone sub-pec implant. Two years later that same area tore during a surgery to repair my allograft material, which was perforating. I have thin skin, had a very thorough bi-lat mastectomy, and had thin pectoral muscles. I had surgery at a time when pre-pec was not yet being done, but I would not have been a candidate due to the thin aspect of my skin. I wanted to post to suggest that you consider fat grafting to your flat side ahead of attempting additional recon. Grafting fat helps improve skin integrity and provides the potential for increased vascular activity and success. Lat flap was suggested to me by my first PS after a number of surgeries as a last resort, but I didn't feel it was a viable option because I have had extensive skin cancers on that area, with more that have cropped up and needed wide excision or Mohs surgery. I did three small grafts to my flat side, over a period of time, and it made all the difference. I changed to another PS and she was able to carefully accomplish my recon. It was a bit of a saga but worked out in the end. Wishing you the best. Here are links to the fat grafting info:

https://www.breastcancer.org/treatment/surgery/reconstruction/corrective/radiation-effects

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

bunny - you're welcome, glad it is helpful! Hang in there - I know this is disappointing, but hopefully a temporary situation. Just wanted to add that the grafts I had were easy - it is a small amount of harvested fat, so super short surgery, minor discomfort at the harvest site. Totally worth it for me, and maybe for you too!

Oh yay! I am sending hopeful energy that this works for you! If anyone wonders why I still post on this site 11 years after being diagnosed your message is the reason. If I can pass on a nugget of info based on my experience that someone finds helpful, that is my silver lining!

Repeat fat grafting may be a bit of a pain because any hospital procedure is more complicated now due to COVID, but it could be the game changer! I just had surgery on 6/8 to replace my ruptured right implant so had to have a COVID test just prior to surgery even though I am fully vaccinated. We replaced the right and also did a swap of the left as well because my implants were textured. Since I was under anesthesia my PS agreed that we should remove the left due to the recall, but she was also able to remove a lot of scarred skin from the front of the breast where I had all these previous issues. That never could have happened successfully without the previous fat grafting I had done, I am absolutely convinced. Despite an allergic reaction to the surgical tape I have not looked this symmetrical and well shaped since my first surgery. I never thought things could look as good as they look right now - I am super happy! In the past I had multiple skin excisions in that same area and keeping those incisions closed was extremely challenging and not always successful. I would also encourage you to consume 100g of protein a day while healing from surgery, and ask your PS about possibly taking extended antibiotics and some extra zinc, bromelaine, and arnica supplements to aid with healing. I found that wearing a compression garment on the fat harvest sites helped manage the discomfort. My first PS required it, current PS leaves it up to the patient for relatively minor fat harvest. Topical arnica gel or cream you can get over the counter helps dissipate any bruising also.

If you use a high waisted panty type garment or body suit with low front that puts no compression over the breast area, make sure you find one with a snap crotch! Trust me when I say you don't want to pull your garment down every time you have to use the bathroom, lol! Something like this:

https://www.target.com/p/assets-by-spanx-women-s-remarkable-results-open-bust-brief-bodysuit/-/A-81397547

It has been five years since my last surgery and the need for this one caught me by surprise. We have no idea why the right one ruptured. It was found on a routine MRI, but never a dull moment. The aesthetic is so much improved it has been worth it! So, yay!

Yes! And solves the problem mentioned above, lol! The only caveat I can provide is that it is important that it doesn't bunch if you are laying or sitting which may be more problematic if it has less structure than a panty or body suit style. I am kind of short-waisted so that has been an issue for me in the past, but hopefully won't be for you. I had a similar one except that it velcroed rather than pulled on, I woke up from the first fat graft surgery in it at the hospital but it was too "tall" for me because it was a one size fits all thing. It created some discomfort so I switched to the bodysuit type.