Implant Reconstruction AFTER Radiation
I have a unique history when it comes to reconstruction. I had saline implants prior to diagnosis and my breast surgeon asked if she could re-implant them when she did my double mastectomy. I then had chemo, followed by radiation. Fast forward 5 years later, and I decided to go for reconstruction. The "old" implants would travel under my armpits when I flexed, as they were under the muscle. My current plastic surgeon decided that the best route was to remove the saline implants and use silicone implants over the muscle. I did the surgery at the end of May of this year. One month later my left/radiated side became red and warm, and I had to have it removed, as it was infected. I was offered to either proceed with a lat flap surgery, or to try an implant once again. I need my lats as I am a dragon boat paddler. I now have a tissue expander on the left side, but the surgeon mentioned that the failure rate is quite high for radiated breasts that have had a previous failure.
Are there any success stories out there? I'm specifically needing to know if anyone had implants post-radiation and haven't had any issues. I'm trying to stay positive but am looking forward to multiple surgeries and procedures down the road.
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I wish I had good news for you, but my experience has not been awesome. I had a direct to implant BMX, but then they found cancer in my nodes so I had radiation. My implants became quite uncomfortable after radiation, so I explanted and had a DIEP in February of this year. My non-radiated side has healed well, but my radiated side...the skin died shortly after my DIEP. I've done surgical debridement, three skin grafts, a reduction/revision, and five months later it's still an open wound. I've tried all kinds of dressings and creams, wound vacs, even vitamins and wound care drinks. Nothing helps. I'm currently awaiting a call from the surgeon's office to schedule surgery #8, and they've done so much work on that side I'm almost flat (was a DD with implants and after the original DIEP surgery). I'm 45 years old with no other health issues, except this open wound we can't get to heal. It's about 3 inches by 5 inches at this point, and I can only be thankful that it hasn't gotten infected yet. My skin was absolutely fine during rads itself, so no indication that the DIEP would cause a problem.
I would consider seeing a couple surgeons for a consult, and asking specifically how they manage skin complications. Do they change up where the incisions are placed, to avoid as much pressure? Do they use wound vacs? What is their recommendation for you?
Good luck!
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My situation is not quite the same as I haven't had a reconstruction failure but I was informed there was a failure risk with a previously radiated breast even the first time. In 2017 I had radiation on my right breast after a lumpectomy. After recurrence this year, I opted for a mastectomy with immediate reconstruction (saline implants over muscle, skin saving, nipple saving). Surgery went well but 10 days post-surgery I developed a dry red scab on my right breast where the nipple is. My breast surgeon is not worried about it but did say it may be related to the previous radiation. He has just instructed me to put an antiseptic on it to help it heal. Post-surgery he also prescribed an oral antibiotic which I will be on for 4-5 weeks to prevent infection. As my mastectomy was on July 1st it is too early to say if there will be an issue but so far my right breast is looking okay other than the small scab over the nipple area. I'll come back and let you know how I get on.
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NNS, sorry to hear about your difficulties! It's really challenging to have issues after all we've been through! I hope things get better for you. I don't know what my options are regarding surgeons. I specifically asked to be referred to this surgeon as he came very highly recommended by many. The only other PS at the cancer centre works very closely with my surgeon. My only other option would be to pay to see a PS but I would need someone who works with breast cancer specific reconstruction.
Dawn68, thank you for your comments and I would be very interested in hearing how things go for you. After all the information I've read, I do think my chances of a second implant failure is quite high. I will ask my surgeon if he has had any patients who managed to tolerate an implant after radiation. I need a wee bit of hope!
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@dutchiegirl just a quick update. It has been 4 weeks now since my mastectomy with reconstruction. The red scab around the nipple area of my right breast (previously radiated side) got slightly bigger but now has gone completely. I treated it daily with alternate antiseptic and high MGO manuka honey (my daughter works in a honey shop 😊). I was also on oral antibiotics for the entire 4 weeks. As of today, both breasts look & feel fine, all signs are it is a successful reconstruction.
Did your surgeon have you on oral antibiotics for a month after surgery?
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@dawn68 Thank you for your response. I was on Cephalexin for 3 weeks after my surgery. I have been or both IV and oral antibiotics since my explant but will be done on Friday. I will ask my surgeon if he will do anything differently when he does the next implant surgery. Maybe stronger antibiotics for a longer period of time? Hoping this next one works!
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