Breast recon/implants -Successful Stories after Radiation
I wanted to find out if there were any success stories on this topic/procedure: Recentently I went to a PS . 4.5 years ago I had a lumpectomy, chemo and radiation. Although, my radiated breast is pretty much the same size, I have always wanted to get the fullness back in my breasts after having kids..etc... I'd always heard that putting in an implant on the radiation side was risky. My PS examined me and said that my breast was in really really good shape after radiation and that I indeed could have implants, the possible capsular contraction risk rises 2 % for me. The only neg he said is that over time your good breast would sag faster than your radiated breast would..just due to scar tissue and that I guess would hold that breast up.
I would certainly talk to a couple PS, just to see what they say. I told the PS all of the horror stories I've heard about putting an implant in the radiatied breast, he told me it has to do alot with your skin type and where the radiation was given exactly. We also talked about future mammograms and how that was very important. PS said by putting the implant behind the muscle is much better for those mammo's.
My delima now,, should I do this? Is this the right thing to do or should I just leave well enough alone? Now that I was given a "Yes can do" I've started to question myself again!!!
Tell me something good 
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Well nuts I have been searching for success stories as well. I had a BMX with immediate TE reconstruction. Unclear margins necessitated the RT. I had to wait a year after the end of RT...before picking up with the expansion. I could have started in March 2012 but waited til May because my son was getting married in April.
I'm told I have good skin. I love my PS and he has not mentioned any concern about my skin. But the muscle is SO tight and painful I have wanted to hear about successful implants following radiation. Are we just to ships alone in the ocean?
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Are you only interested in implants or would you be interested in other methods?
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I think I'm only interested in implants. I wanted to be a C cup, which is DOWN from the DD I was before surgery. But I'm at a B cup now. the PT believes he can release scars inside and get me to the c cup. I've read lots of stories of women who hated their reconstructions. But I'm not looking for beautiful foobies. I want to fill out a bra, look normal in a dress. My goal is that people who haven't seen me in 4 years or so will just think I've lost some weight. I don't care about rippling or other things that are only seen while nude.
But the TE is so painful. I've wanted someone to hear from someone who had the TE and the implant and felt it was worth it. I WANT to hear the pain if from the TE and won't be the same with the implant.
My PS doesn't do any flap work. But I have 2 friends who had different flaps, one from the back the other from the belly. Neither of them are happy with their results. The one from the back feels hers are too small, and they do kind of disappear in a blouse. They hang like excess skin on an obese person who loses a lot of weight. The other girl had the abdominal one, and she's okay with the size. One appears to be fine, but her right side "travels". One day it will be hiding under her arm, the next crowding in the middle and another day nearly under her chin. Obviously something is not right. Both were in ICU for 4 days, while the nurses watched the blood supply to the new foobies.
I have a diabetes complication, so I don't even want to talk about the flaps.
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fragrantroses, to get good flap results, you will need to travel, probably to NOLA. I had radiation, BMX, and now have implants and I am not happy. they were successful - no failure or anything - but they are tight and asymmetrical. I am looking into a PAP flap or fat grafting at the moment.
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sweetbean - what is NOLA? never heard of that here in canada
i am in the same situation, kind of
i had chemo.lumpectomy and rads. I am having a bmsx in september (6 mos after completion of rads) Both PS told me I would have to have the lat dorsi flap procedure on the radiated side. I am not really happy about this due to the scar that i will have on my back. And it doesn't sound like the results are optimal either as frangrantroses notes. I am not a candidate for the belly fat procedure
if you have a skin sparing can you go direct to implant?
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throw me in this group, i would like to hear some success stories. I had a bmx in March, I had lump/rads in 08, lucky me, it came back. my radiated side is not doing well. the skin on the bottom is not streching the same as the left, healthy side. the fluid is going up high and to the side, not below (inferior quadrant as my PS says) He is doing LD flap in Aug. (I need to put off a bit for work reasons) I am praying for a good result! sounds like in many cases, the flap is a flop! hmmmm.....
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NOLA is New Orleans, Louisiana. For whatever reason, many of the top PS's in the country have offices there. They are super experienced and I think they fix a lot of disasters.
Rozem, I am not a candidate for the back or belly flap procedures. Look up PAP flap - pretty much everyone is a candidate for this, but it's really new. And I am also looking at the BRAVA with fat grafting.
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Count me in as someone who would like to hear some success stories. Will be seeing PS on Tuesday to look into options. Not really leaning towards recon, but do want to know what's out there. I've also been told that Lat Flap is the only way for me to go, but we shall see.
I am only looking to recreate my A cup and wonder if that is worth the risk and trouble.
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Kestrelgurl, have you looked into PAP flap? It is an option for just about everyone. It takes the fat from the bottom of the buttock and the top of the upper thigh. Think "butt lift." I just found out about it and am now considering it. I have implants and am not happy, although they did not fail. I just don't particularly care for how they look. (They look great in clothes, just not so stellar naked.)
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I will say that there are several women on here who did radiation and implants and are very happy with the results. It is definitely possible, although you will very likely need a revision to deal with asymmetry. (The non-rads side will drop and fluff, but the rads side probably won't.)
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sweetbean - i think my PS did mention this but does not like to do it because it causes more skin issues like dimpling - I will ask again when i see him on Tuesday
thanks for the explanation on NOLA - as a canadian i had no idea what that stood for
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Count me in on wanting to hear some stories too. I am scheduled for a UMX in August and my tumor is/was close to the chest wall, so I have to schedule a consult with an RO to find out if I need rads. I am so disappointed that I might need rads, and scared about how it will limit my reconstruction options. Was tentatively planning on implants but have not met with PS yet.
tift2008 & fragrantroses - I am in Missouri too!
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Thanks everyone for your replies. I'm having another consult with a differnet PS this Wednesday, we'll see what options he suggests. I plan to get 3 different PS opinions before making a decision. As I have those I will pass along.
I'm in the Kansas City, MO area.
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I had radiation then BMX with TE's. I still have my TE's in place and will have my exchange mid august. I have had no problems with them at all. I do have thin skin but PS is not terribly worried he says everything looks good. In the beginning I was thinking about DIEP flap because so many people talked about it. Contacted NOLA but they did not take my insurance. I started asking around and found a group in San Antonio called PRMA and they primarily only do breast reconstruction and do all the flaps and lost of them. I ended up not being a candidate for DIEP because I am really thin and very little belly fat. PS thought for me TE's and implants would be the best. I had a friend who lived in New Orleans and had two failed flap surgeries. She moved to Texas and went to PRMA and had a successful flap surgery. She was never unhappy with her NOLA Dr's but said she was more impressed with PRMA.
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Hi ladies, here's a super success story for you...four 1/2 years ago, previous lumpectomy and rads and a huge divot out of my left breast.
New cancer, close to chest wall. Only option mastectomy. Rads skin generally cannot hold up the new implant by itself. Some times a Dr. will try it, but it is risky.
Think wet tissue paper. With about the same strength. My PS (Dr. David Passaretti, Aesthetic Surgery Center, Darien, CT) is a serious miracle worker.
He did a lat flap. Actually, Dr. James Gadzick, Westport Surgical Associates, Westport CT, did it. Another miracle worker.
Then they used the latissimus dorsi muscle and put it underneath. I did have major complications. I had necrosis, etc. Dr. Michaelangelo Passaretti patched me from my c section scar.
4 1/2 years later, I have a beautiful non saggy breast that looks just like a slightly smaller version of the original. The non reconned lady is a droopy gal and will be downsized to match the new girl t his summer by Dr. P.
Lat flap is NOT for the faint of heart. It's a major operation and you do have a chance of remaining numb. I actually regained all feeling, (told you he's a miracle worker) and the parts he patched are barely visible. If you will commit to doing stretches and PT, you won't get the iron bra effect some women get.
I mean, you still might,no guarantees, but the stretches I got eradicated it.
So, it can be done!!!!
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There is a new surgery where they inject fat first and then a couple of months later put the implant in. I posted on the Ask an Expert board and was told they are doing this surgery now. The fat forms a cushioning for the implant and helps avoid many of the problems from the radiation. Sounds promising.
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KatiKay,
This is what the PS I saw today recommended. He says that the fat injections have been very successful in preparing the irradiated tissue to accept TE's and eventually implants. Although the process will be long on the front end (2-3 injections @ 3 month intervals) it should make for an easier surgery and recovery down the road.
PS estimated my chances of a successful recon with this protocol (fat injections --> TE's --> implants) as being 80-90%.
And there really doesn't seem to be much of a downside. If the fat injections don't work, there is still the flap option.
I scheduled my first injection for the end of July.
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I have a PS appt today and was going to ask them about the fat injections...where do they get the fat? from where on our body??
I will let you know how my appt goes
Tiff
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Hello all,
I was diagnosed last year with bc. I had a lump, chemo & rad. My last treatment of rad. was Jan.6, 2012. I tested positive for BRCA so my Onc. recommended a bi-lat. mastec. and removal of ovaries. I'm scheduled to have my ovaries procedue July 25 and my bi-lat. Aug. 8th. I was told I would have to have the back flap. I don't know if I'm filled with too much info. but i'm still a little confused why the back flap. Also I'm worried about the healing process. My PS said she wouldn't construct the radiated breast right away. I'm also worried about looking at myself with 1 boobie. Can anyone offer insight?
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mspoto I had rads and then a BMX I saw three PS and all said I had to wait 1 year post rads before I could have the BMX. The one I choose evaluated me again at the end of the year to make sure he was comfortable with the TE and implants. All has been good. I understand that the long out you are from rads the better your tissue heals.
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I think I'm a pretty happy success story! My mastectomy was in Jan. 2010 (left side) followed by 38 radiation treatments. In March of this year I had Lat Flap reconstruction with a tissue expander, and 3 weeks ago I had the exchange to a silicone implant. My PS also lifted the right breast. I couldn't be happier with the results! The rads side has healed nicely, the skin is in great shape, and the match to the right side is just amazing. I feel so good in clothes again! PS told me to massage the rads side a couple of times a day.
The lat flap surgery was not nearly as challenging as I thought it would be, and it laid a great foundation for the reconstruction. I did take several weeks off from work afterward though. The PS has been a champ through this whole journey!
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Success! I had mx in 5/11 with TE placed. Some expansion, then 33 rads followed by more expansion. Waited 6 more months and then had exchange last week. I didn't have very good skin after rads so had inframammary fold incision. So far, so good and it looks pretty good!
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Thanks for sharing all the stories. This is all so overwhelming.
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hi ladies
just wanted to post as i had my consult and sign off on surgery with my PS today. He is the head of plastics at 3 top hospitals here in canada. This is what he told me:
1. best results after rads IN HIS OPINION is with a lat flap on the radiated side, he said that the results with pap flap (from your buttocks) is not good (dimpling etc in that area) and they do not do it
2. direct implant would barely give you an A cup - for anything bigger (i am a
you have to do the the TE route3. alloderm to avoid the lat flap is only used in clinical trials here. If you can get it this is an alternate to lat dorsi flap
so it lookes like lat flap with TE's for me
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Good morning.
I had my 2nd ps consult yesterday! Basically he confirmed the same thing as my 1st ps consult. did
He said my radiated side would be fine with implants. Keep in mind I've only had a lumpectomy, not mx, so I've still got a lot of tissue. Both PS said it becomes a problem when one has had a full mx with radiation...trying to stretch less skin! I hope I made sense there /:- My other option is Fat Injection, but that would not give me the fullness on top I was looking for. And certainly more surgeries to accomplish the best result... So now I just have to decide to go through with it or just live with what I've got?.... I'm most scared about another surgery and being cut on..yikes! that always scares me. And then of course would if there is complications later.?.....Good luck to everyone with you're decisions and procedures
Have a really great day!
Tiff
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I had a left MX in June of 2010. Had TE at same time, not knowing then that I would have to have radiation. So I had TE in place during radiation. Finished radiation in September 2010 and had exchange for implant in December. Implant was too small and I had it replaced in April of 2011. After one year with new implant I am still unhappy with size. It seems to have shrunk. It also has some hard places around the edges, from scar tissue, and has a bumpy appearance underneath the reconstruction site. While I can live with results, I am not as pleased as I would like. My PS is talking about DIEP flap. I'm wondering if radiation will cause problems with this surgery as well. Does anyone have experience with a DIEP flap after radiation? Are you pleased with results?
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scootergal I think DIEP flap is pretty successful after radiation damage because they are able to microsugically reconnect needed blood vessels.
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Thanks, Sherryc! I'm scheduled for a DIEP flap on August 31st, but had been having some concerns lately and that's why I posted my questions. I think I'm feeling a little more positive about it. Just wish I could fast forward to having the surgery behind me.
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scootergal good luck with the DIEP from everything I have heard about it I think you will be very pleased
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I'm glad to hear that people are experiencing results from radiated skin. Maybe I missed it, but I did not read anyone who did skin sparing mastectomy with immediate TE. THEN I had 33 radiations. Waited the year for recovery. My skin healed up despite getting all wigged out by horrors stories of extruding implants. I was never interested in any flaps, as I'm diabetic. I wanted tissue expanders to implants.
However, I'm not feeling so wonderful. I had the exchange surgery yesterday. It got rushes a bit at 750 cc's because I sprung a leak on the radiated TE. They expanded it to 660 without problem, then it started to leak. They added 90 to it and it leaked. Confirming it was a LEAK and not just a relaxing capsule. They filled me to 750 and for the first time in my life my expansions were not painful or felt like we were breaking ribs.
I wanted the largest out there....I used to be a DD, so I wanted to look like me, but having lost weight. I had been told that a round 800 cc silicone cohesive gel would give me the C cup I wanted. I told the PS I wanted the 800 cc implant with the most projection. And that's exactly what he gave me according the card...800 cc with high profile.They took the dressing off this morning, and there's nothing there. I'm flatter than TE, I have two round biscuits. They are large in diameter, but no projection. I'm wearing a cotton "leisure" bra that latches in the front. As flat across the front as I am, I don't expect to ever be able to wear a real bra. If feels like I wore a concrete bra for 19 months for no reason what so ever.
That is the only benefit so far....no concrete bra. It looks I will still be wearing those freaking hot mastectomy bras. My goal was to look good/normal in a dress. But manufactures all believe a size 22 W means a busty girl. So those dresses don't look normal. I wanted a c cup so I looked like I lost weight, but no like that woman with no boobs.
I've tried to get on the photo pages that are moderated. I have messaged everyone that people said to message. They either don't show up as members in members search, or the 2 I have sent messages to, never responded over the last 2 months. So I don't know if this is normal for the day after surgery or did I really just waste the last 19 months for fried egg boobs.
I just needed to vent. No one has to respond. I'm just dishearted and don't want to tell my husband, who is very supportive and said he was fine if I chose to not reconstruct at all. When I told him I was shocked how flat I was when I looked in the mirror, he told me that while the work all looks clean and tidy - he was also shocked how flat 800 ccs looked and he had a suspicion that I wasn't not going to be happy.
I never wanted to be one of those women who keeps telling her doctor go larger until I'm Pamela Anderson or worse, Dolly Parton (although I'd take her tiny waist).0