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Topic: Radiation & Reconstruction

Forum: Breast Reconstruction — Is it right for you? Discuss timing and various procedures and techniques.

Posted on: Jun 11, 2007 04:58PM

Jinx wrote:

Has anyone had radiation and then reconstruction?

I had lumpectomy - recurrence near lump bed - but had radiation. Mastectomy in Jan. for second cancer

No one told me radiation might disqualify me for reconstruction. I am so upset by this.

I wish I had a mast the first time around - I would have had immediate reconstruction.

I have apt. with surgeon in two weeks.

I am so upset by all of this. I can't believe no one told me that radiation = maybe no reconstruction. I was stage 1 first (2 1/2 yrs ago) and second time. Log in to post a reply

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Posts 1 - 21 (21 total)

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Jun 11, 2007 05:34PM GoodMommy wrote:

I had radiation and waited a year to have reconstruction because I wanted to have expander/implant surgery. I was advised against this particular kind of reconstruction because of the radiation. I had it done anyway and it failed miserably. I ended up doing a lat. flap and so far I'm very pleased. You should be a candidate for a flap surgery or a DIEP or SGAP. There are many different methods that should still work. Good luck with your appointments.

God bless,

Chris
Dx 3/2005, IDC, 1cm, Stage IIIA, Grade 3, 15/20 nodes, ER+/PR+, HER2-
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Jun 11, 2007 06:13PM - edited Mar 11, 2008 11:40AM by BethNY

Radiation does not = NO reconstruction, and if anyone tells you that you should slap them. Okay, don't slap them, but maybe stand really close when you talk to them, and try to spit on them.
I digress...

While radiated skin does pose challenges to plastic surgeons, there are many methods of reconstruction that are successful after radiation. The easiest methods would be an abdominal flap surgery, however, if you were only a candidate for implants, you could combine them with a lat flap, or alloderm depending on the amount of radiated tissue that needs to be salvaged, and voila--- breasts.

you need to find the right Dr., and go from there.
good luck
Be your own hero
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Jun 11, 2007 06:49PM ladyinbrevard wrote:

Although radiated skin can present problems, it is not a foregone conclusion that an implant reconstruction is not a option. I had a lumpectomy ten years ago followed by radiation treatments. Two months ago I had a recurrence in the same breast. I decided on having this type of construction because of the advantages it offers: a far simpler surgery which does not weaken any other areas of the body and a much easier recovery post-surgery. On June 6 (five days ago), my PS used Alloderm to create a sling which supplements the muscle and there was enough skin post-mastectomy for him to immediately put in an implant, skipping the expander entirely. The implant was the same volume (gram for gram) as the tissue which was removed. So I am here to say, yes, there are many choices out there and you should investigate them all to decide which is right for you. The implant method is one of your choices.
I wish you strength during this difficult journey. I made it through and with the help of your loved ones and friends, so will you.
God Bless You,
ladyinbrevard
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Jun 12, 2007 07:04AM nancysmile wrote:

I am due to have my perm implants put in 6/21. Had first occurence of bc 2001 - had lump/radiation. Second recurrence last Aug = had bilat mast with immediate recon. PS said only 'wrench' in the deal was the radiated breast. Had one 'fill' am a nice "B" cup. All going great, but just developed a small scab on radiated breast scar. PS concerned = not infected - says he's never seen this so far out into recovery. Saw his PA Mon and going to see him today. If i have to postone exchange a few weeks it's fine. I've been questioning my decision and will take his advice . I truly respect his knowledge. I don't want any more problems but i've come so far and enjoy having a nice bustline. I'm only 48! SO....i would take a chance and go for it, but be prepared for some 'bumps' in the road. Good luck. I plan to post here my outcome asap.

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Jun 12, 2007 07:34AM roseg wrote:

I am sure that some people have success with expander/implants after radiation. The best scenario seems to be where you have the expander and get expanded BEFORE the radiation. Then they radiate the expanded tissue. Even then sometimes I read about discomfort, infection, or unsatisfactory cosmetic results. But oftentimes that seems to satisfy people.

It just seems like so many women have problems with expander/implants after radiation that I think I would give serious consideration to another type of reconstruction if I'd already had radiation.

It's stressful to have it and then have it fail, why not just go with a method you're sure will work.

I don't want to be disrespectful of Plastic Surgeons, but they get paid whether it works or not, and if it doesn't work they stand a chance of getting paid again to fix it. So if you are really against a more involved reconstruction method, like a lat flag, TRAM, DIEP - I think they will try the expander/implant.

But you are the one going through multiple surgeries and spending your time and emotional energy, so I would listen to the PS when they tell you what the chances of success are.
Rose
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Jun 12, 2007 08:48AM The_Cyber_Cat wrote:

I know a woman who had very bad skin damage from radiation. She had a recurrence in same breast after lump. (had mast second time) Her surgeon told her same thing - probably no reconstruction due to radiation damage.

But the plastic surgeon - who agreed her skin was damaged -was able to do reconstruction for her. She was very pleased with results.

So, since she was able to do it with badly damaged skin you most likely will succeed too.

Don't panic till you talk to the plastic surgeon. And I would suggest getting a second opinion.

From other posts I have read it seems almost anything is doable with reconstruction.
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Jun 12, 2007 09:41AM pinkribbon48 wrote:

I had mastectomy, expander placed at the same time, chemo, exchange for implant, then radiation. Implant failed and got worse over time! Refused to have a tram. Researched and found the diepflap.com website. Had surgery to remove implant, get a prophylactic mast. and bilateral diep reconstruction 3/13/07. Best thing I've ever done for myself!!

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Jun 17, 2007 05:14PM Jinx wrote:

Thanks to all who responded. I have now made a second apt with another reconstruction surgeon. Have been reading all posts on reconstruction.

Seems many go to New Orleans or South Carolina! i guess I need to find out if my insurance will pay for reconstruction if its outside my state.

I'm beginning to think this is where the reconstruction experts are!
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Jun 18, 2007 03:21AM cbl wrote:

There are reconstruction experts everywhere depending on the procedure. In addition to their expertise, it is important that you feel really comfortable with the doctors and hospital that you choose. You are going to working with them and seeing them on a very regular basis. Traveling for your reconstruction is not for everyone. Since you are doing the research anyway I recommend you research what is available near you in addition to the "national experts".

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Jun 23, 2007 05:12PM nancysmile wrote:

PS was concerned about scab so had exchange last thurs 6/14. So far he's pleased - all went well but he warned me that he wants to watch radiated breast very closely. Am nervous but hopeful. It's tighter but both look and feel great.

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Jun 29, 2007 03:13PM micheledet wrote:

This is my first post. I had radiation April,2006 due to DCIS. I later was found to be BRCA2 positive and was recommended to have a bilateral mastectomy. I decided on expanders despite radiation. My PS used alloderm on both breasts. I was wondering if anybody has experienced extreme skin sensitivity post op. My surgery was three weeks ago and everything is healing well. My radiated side is better than my prophylactic side. Both sides are extremely sensitive to any touch or clothing, especially around my breasts and under my arms. Actually any spot that doesn't feel numb is sensive. I am taking ibuprofen and using cold compresses. My surgeon says that some women experience this but not all. I am discouraged because I am very active and this is the only problem I have as of now.

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Jun 29, 2007 03:24PM slanderson wrote:

Hi, Michele,

I had lumpectomy and radiation. After that I got silicone implants about 3 1/2 months ago. Right after the surgery, my skin on the radiated side was SOOOOOOO sensitive. My clothes felt like sandpaper. This went on for about a month. Gradually it went away and one day I noticed that I didn't notice anything, if you will. The radiated side is still a little sensitive compared to the other side that is totally normal, but I don't really notice it unless I try to.

Shannon
Shannon Dx 7/13/2005, IDC, 1cm, Stage I, Grade 3, ER-/PR-, HER2-
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Jun 29, 2007 03:49PM michelen-2006Jul27 wrote:

Thanks for replying Shannon. Was there anything you put on your skin to help with sensitivity? Strangely both sides are extremely sensitive. My left underarm is extremely sensitive and still a little swollen. I wonder if it has anything to do with too much activity? What type of bra or undergarments did you wear? Sorry for so many questions but my PS didn't have a lot of advice.
Michele
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Jun 29, 2007 04:02PM slanderson wrote:

Well, during the most sensitive time, I didn't wear a bra at all. I couldn't. I would try and could only take it a few hours. It would hurt so bad that I would be sure it must be red and bleeding and of course it looked perfectly fine. It was just nerve endings. My ps said that it was the nerves waking up. I didn't put anything on it, in fact, I tried to touch it as little as possible. I am a stay at home mom, so I was able to just wear a light t-shirt around the house. If I had had to go to a job, I guess I would have done the same thing because I couldn't stand the irritation. I read a post of another lady on this site that had it on both breasts, radiated and not. I guess everybody's skin reacts differently. I would just wait it out. I have heard of it enough that I think even if it's not typical, it's also not abnormal.

Good Luck, Shannon
Shannon Dx 7/13/2005, IDC, 1cm, Stage I, Grade 3, ER-/PR-, HER2-
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Jun 29, 2007 06:47PM Erica wrote:

Hi Michele,
I had bilateral mastectomies and no reconstruction. One side had previously been radiated. I experienced the same thing you're describing. It started about a week or so after surgery and lasted altogether for 3 or 4 weeks. I was excruciatingly sensitive, so I really empathize with what you're going through. My physical therapist suggested that I wear satin or silk camisoles or tee shirts. That was great advice. I had some old Wintersilks silk tees and wore them. The silk or satin slides over the skin in a way that doesn't irritate.

Given my experience with sensitivity and that of other women I've heard about, I think this is something that happens to some of us regardless of whether we've had reconstruction or not. And my unradiated side was equally sensitive as my radiated side. In my case, I think nerve regeneration was part of the problem; also, I had a delayed reaction to the bandages which probably also contributed. Hopefully, your sensitivity will disappear soon, but meanwhile, if you can find some satin or silk, that might help.
BreastFree.org (breastfree.org); BreastFree Blog (breastfree.blogspot.com); Twitter @BreastFree
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Jul 1, 2007 05:23AM micheledet wrote:

Thanks for your words of wisdom. I guess all I can do is wait it out. I am allready doing what you suggested by wearing a loose fitting shirt and only wearing a loose fitting sports bra for when I walk for exercise. I have a camisole I wear when going out to run errands. I can only stand it for a short while though. I told my husband last night that if the expanders/implants fail then I am not going to do anything. I will just wear a bra with silicone gel in the cups or whatever. I have had enough surgery from lumpectomy, hysterectomy, colonoscopy(not surgery but close enough), to mastectomy with expanders. I know most of you understand what I am saying but I just need to voice it. Now all I can do is wait to see if my body rejects the implants. I had hoped to have things resolved before the school year starts in Aug. I have a hard time envisioning teaching PE with my skin as sensitive as it is. Sorry for griping! Just a little frustrated. I know I am not alone and you have helped with your replies. Thanks, Michele

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Jul 2, 2007 11:27AM Valeriex wrote:

What size silicone did you use? I have had lumpectomy with radiation. Gone thru chemo and of course now in menopause. I am currently a small b cup. I am 5'6" and 125 lbs. Don't want to go big but also don't want to go through all of this and see no change at all. I am trying to get more fullness without too much projection.

Dx 5/15/2003, IDC, 2cm, Stage IIB, Grade 3, 2/14 nodes, ER+/PR+, HER2-
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Jul 3, 2007 12:38PM slanderson wrote:

Valerie,

Are you having a mastectomy or just implants?

Shannon
Shannon Dx 7/13/2005, IDC, 1cm, Stage I, Grade 3, ER-/PR-, HER2-
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Jul 3, 2007 01:24PM MaryGirl wrote:

I'm 9 months post-diep (bilat, no rads) and still have problems with breast skin sensitivity. It's not bad when I get up each morning, but by the time I get home from work I can't wait to get that bra off and have some relief. Like someone else expressed here, I'm also surprised when I look in the mirror after work that my breast skin isn't raw and burnt-looking. My PS says it's due to the nerve damage. I suppose this is getting better over time, and most people seem to be past it in a matter of weeks, but I sure am tired of it all.

Mary
dx 8/06, bilat mast w/DIEP 9/06
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Jul 4, 2007 07:18PM Valeriex wrote:

Shannon,
I have had a lumpectomy on the right breast. No mastectomy. I may have to use different sizes to even things out.
Dx 5/15/2003, IDC, 2cm, Stage IIB, Grade 3, 2/14 nodes, ER+/PR+, HER2-
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Jul 6, 2007 12:30PM slanderson wrote:

Valerie,

That is exactly what happened to me. I got implants because I wanted to be even again. Please make sure that you get the right, best ps. Radiation messes everything up. So you really need a ps who can assess YOUR skin to make sure that it has a good chance of working. Many ps's will say "I'll give it a try". That isn't good enough. He should be able to look at your skin and say it looks good enough or not. The main thing, though, that determines whether or not it will work, meaning no encapsulation, is not going too big.

Can you tell I'm on a soap box? Sorry, I don't mean to be, but I see so many women that say their ps said, okay, I'll try it, or absolutely not, without even looking at them. I was very lucky to have such a good ps. He told me the deal from the beginning. Now, having said all that, I have had a good outcome. As good as one can have with radiation. The radiated side implant is tighter and won't move, but it feels soft and looks great. Feel free to pm me as there are very few women who go this route.

Good Luck, Shannon
Shannon Dx 7/13/2005, IDC, 1cm, Stage I, Grade 3, ER-/PR-, HER2-

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