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Topic: Radiation and Failed Reconstruction, Is there still hope?

Forum: Breast Reconstruction —

Talk with others facing decisions about whether or not to have breast reconstruction, and if so, what type and when.

Posted on: Aug 20, 2021 06:10PM

Biessy wrote:

I have had a bilateral mastectomies, chemo and radiation. I had expanders from the start. Implants were later put in but were misshaped and now, 4 years later, I have attempted reconstruction on both sides. My doctor thought a Latissimus Dorsi Flap with implants would work for me. Unfortunately, 2 attempts failed with seromas forming with infection. The seroma was partially removed recently with the remaining pieces stuck to my rib cage.

I am truly at a cross road. Due to my chemo treatment, I have alopecia leaving me looking like a man with patterned baldness. I am a fairly tall woman at 5'10". With the lack of a figure, I am quite often called sir, man and my drivers license even had me down as a male until a cashier noticed it. I was devastated. I wear wigs or a hat when it is cool enough, but I live in Georgia... As I saw another woman post, it is still very difficult to look at myself in the mirror.

My question is, am I out of options? Do I need to just suck it up? The thought of a prosthetic in this climate is so unappealing, especially since I inherited sweat glands on overdrive.

A plastic surgeon in another state who had to do an emergency removal of my implant, said that it could be repaired and look really good I just want to know if anyone has any experience with his kind of situation...

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Aug 20, 2021 10:09PM Moderators wrote:

Welcome, Blessy. We're so sorry to hear of your experiences! We certainly understand how hard these setbacks can be, on top of everything else. We're sure other members will chime in with their experiences as well - so many of our members have been through similar. And it sounds like the plastic surgeon who removed your implant is confident in the potential outcome. But we absolutely understand how you feel in this moment. You're not alone!

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Aug 21, 2021 09:00AM Monarchandthemilkweed wrote:

I can’t answer your specific questions but did want to come here and say I’m sorry for the struggles you’ve gone through. And looking at your profile picture, you look nothing like a man! I hope someone comes along and can answer your specific question soon!

Sarah, Chek2 positive Dx 3/11/2021, IDC, Left, <1cm, Grade 2, 0/2 nodes, ER+/PR+, HER2- Surgery 5/9/2021 Lymph node removal: Sentinel; Mastectomy: Left, Right; Reconstruction (left): Tissue expander placement; Reconstruction (right): Tissue expander placement Chemotherapy 6/27/2021 Cytoxan (cyclophosphamide), Taxotere (docetaxel)
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Aug 21, 2021 01:31PM SuQu31 wrote:

I agree you do not look like a man at all! But what is important is how you feel about the way you look. I chimed in because I also live in the South and agree that the heat and humidity are bad enough without adding layers of anything! I think you should consider talking to other plastic surgeons for your own peace of mind, so you can satisfy yourself that you have considered all options. Even if you decide not to move forward with additional surgery, it will feel different.

I have seen information on these boards about a reconstruction option in New Orleans where they seem to specialize in difficult cases. Sorry I don't have more info, but I'm sure you can find it by searching the site. That may be an option not too far away from you.

Re-excision for close anterior margin 10 days after BMX. Dx 10/31/2018, DCIS, Left, Stage 0, Grade 3, ER-/PR- Dx 12/10/2018, DCIS, Left, 2cm, Stage 0, Grade 3, 0/3 nodes, ER-/PR- Surgery 12/10/2018 Lymph node removal: Sentinel; Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left): Latissimus dorsi flap; Reconstruction (right): Latissimus dorsi flap Surgery 12/20/2018 Surgery 9/13/2019 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant
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Aug 21, 2021 03:21PM Biessy wrote:

Thank you!

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Aug 21, 2021 03:38PM SpecialK wrote:

Biessy - have you ever spoken to a plastic surgeon about having fat grafting to the radiated skin to help it strengthen and gain integrity so you can attempt implant recon again? Here is a link to some info, and there are a number of pages:

https://community.breastcancer.org/forum/70/topics/744891?page=7#post_5464066

I believe SuQu above is referring to the Center for Restorative Breast Surgery in New Orleans. They specialize in difficult cases, and particularly autologous surgery as they have pioneered a number of those procedures. Here is a link to their site:

https://www.breastcenter.com/


BMX w/ TE 11/1/10, ALND 12/6/10. 16 additional surgeries. TCHx6 2/17-6/2/11. Herceptin until 1/19/12. Femara 8/1/11, Arimidex 6/20/12, back to Femara 2013-2018. Dx 9/27/2010, DCIS, Stage 0, Grade 3 Dx 9/27/2010, IDC, Right, 2cm, Stage IIB, Grade 3, 2/14 nodes, ER+/PR+, HER2+ (IHC)
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Aug 21, 2021 06:08PM Spookiesmom wrote:

I’m on the short side, 5’4”. What little hair I have is white, very short, extremely thin. I wear gold rim glasses with white Pearl arms. I’m also flat.

I get called sir frequently. When that happens I growl back it’s ma’m. And laugh to myself while they apologize.

It’s too hot in Florida for any type of head cover, so I don’t.

Hope this helps.

First time IDGgrade 3, stage 3. Second time, found lump myself. That made me stage 4. Dx IDC, Stage IIIA, Grade 3
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Aug 21, 2021 06:44PM SuQu31 wrote:

SpecialK, that’s it. Thank you for providing that info! And I realize what I said about feeling different might be unclear- what I mean is that, if it is your choice, it will seem different to you than if you feel you were forced into any particular decision.


Re-excision for close anterior margin 10 days after BMX. Dx 10/31/2018, DCIS, Left, Stage 0, Grade 3, ER-/PR- Dx 12/10/2018, DCIS, Left, 2cm, Stage 0, Grade 3, 0/3 nodes, ER-/PR- Surgery 12/10/2018 Lymph node removal: Sentinel; Mastectomy: Left; Prophylactic mastectomy: Right; Reconstruction (left): Latissimus dorsi flap; Reconstruction (right): Latissimus dorsi flap Surgery 12/20/2018 Surgery 9/13/2019 Reconstruction (left): Fat grafting, Silicone implant; Reconstruction (right): Fat grafting, Silicone implant
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Aug 22, 2021 10:03AM sbelizabeth wrote:

Biessy, as a couple others has recommended, call the Center for Restorative Breast Surgery in New Orleans. They specialize in challenging cases and have lots of women who travel for their surgeries. They have systems in place to help figure out the travel details. I've seen the work they do--it's nothing short of amazing.

pinkribbonandwheels.wordpress.... Dx 10/20/2011, IDC/IBC, Left, 1cm, Stage IIIB, Grade 2, 6/28 nodes, ER+/PR+, HER2- Chemotherapy 12/15/2011 Adriamycin (doxorubicin), Cytoxan (cyclophosphamide), Taxotere (docetaxel) Surgery 4/18/2012 Mastectomy: Left Radiation Therapy 5/21/2012 Breast, Lymph nodes Hormonal Therapy 7/19/2012 Femara (letrozole) Surgery 4/15/2013 Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap
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Sep 8, 2021 02:30AM - edited Sep 14, 2021 08:19PM by macb04

I just wanted to say that a few Fat grafting procedures and multiple Hyperbaric Oxygen Therapy sessions helped immensely.

My skin was thick and inflexible, like cheap leather. I figured out myself that I had severe radiation fibrosis and found Hyperbaric Oxygen (HBOT) at a Wound Care Center near me.

HBOT was covered by insurance, under soft tissue radio necrosis.

My skin became supple again with both therapies. Then I finsucceeded at reconstruction.

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