reconstruction
 

I was wondering if any of you have had successful reconstruction after radiation and if so what type?
I've read on here several different types of surgery.
Thanks

Re: reconstruction
 

I had successful bilateral DIEP reconstruction after radiation. I was dx in June of 2005.....had surgeries, chemo, herceptin and radiation all ending by October 2006. I had my reconstruction....delayed bilateral DIEP in June 2008. Very successful.

7 year NED survivor and going strong.

Mary Jo

Re: reconstruction
 

Did you have reconstruction and did it go well?

Re: reconstruction
 

I had my reconstruction in Dec along with all the other proceedures (nipple, and tatoo). I did latissimus dorsi flap and love the results. I tell everyone my new boobies are better then the old ones. Recovery is a little tougher as you have two incision sites had to do some physical therapy to work on scar tissue and range of motion.

Re: reconstruction
 

I did have an expander in and a implant on my non-cancer side but I couldn't take the pain and had them removed not long after they were put in. I was thinking I might have better luck the second time around. I really think they weren't put in correctly because the pain was horrible.

Re: reconstruction
 

I didn't have radiation but I also had reconstruction and I found the expander very uncomfortabe and hated the fills, it got more comfortable with time, once it was removed it all went well. I just got my nipple yesterday and everything looks pretty good. I thought that I was the only one that experienced the pain with the expander since no one really ever complained. It was horrible for about 10 days. The implants are something I had to get used to. Did you talk to your surgeon about other options? My surgeon explained all the procedures to me and I went with the less recovery time. Its a personal decision, I hope things work out fpr you.

Re: reconstruction
 

I had bilateral radiation and then 7 yrs later had stage I with mastectomy and DIEP (bilata) It made the surgery a bit more difficult, but my surgeon did very well and I am very happy.

Re: reconstruction
 

I had bilateral reconstruction after radiation. I was not willing to do anything else to upset/scar my body so would only opt for silicone implants. I knew that implants were not recommended after radiation but I had had skin sparing mastectomies, took really good care of my skin during all my treatments, and waited a year after radiation to go directly to implants, no expanders. I had been a C cup and was happy to go with A cups to make the surgery less difficult. I have now had nipples created and am happy with the whole result. My ps said there are often problems when trying to use tissue grafts to create two mounds so I think he was relieved when I said I wanted only to try for implant reconstruction. I had my ps promise me that if the surgery did not work out then he would return me to my previous flat chested state. The radiated side is an adequate breast and the other breast is lovely so I am probably no different than a woman that had a lumpectomy done. I am probably overly critical and my very wise husband tells me both breasts are lovely. All the best, Carolyn

Re: reconstruction
 

I am not sure how to start my own thread so I am tagging along with this one since my question is pretty much the same. Has anyone been successful at expander/implant reconstruction after radiation? I am going to have my exchange surgery in November and I am terrified that it is not going to work. I have taken really good care of my skin and I have not expanded that much. I only know a few women who have done this route after radiation and theirs all failed after the exchange surgery. I would just like some hope!

Re: reconstruction
 

i just had a bmsx 6 days ago. I had a lump and rads 6 months ago. I have expanders with a lat dorsi flap on the radiated side. I was told i had to do the flap procedure b/c of damage to the rads side. Recovery has been really really tough. But i have to say the pain in the front is worse then the excision on my back. I thought it would be the reverse. I have been filled to 160cc already and the pain has become more of a tight sensation. My PS has done hundreds of these and tells me the failure rate after the implants go in is very low b/c the flap has created a proper sling for the implant

Re: reconstruction
 

Hello:
I had a mastectomy, chemo and radiation in 2009.
This wednesday I'll have an appointment with the surgical dr.
I want to know what is the best reconstruction, and how is the recovery if is a flap.

Re: reconstruction
 

I had reconstruction on radiated side after surgery. I waited almost two years before starting. I have silicone implants and it worked out fine. My skin proved to be healthy enough to try it. Most PS don't want to try it. I'm happy with the results.

Re: reconstruction
 

Thank you Ruth!!
That's great, I'll ask about implants..

Re: reconstruction
 

I just had reconstruction. I only lost one breast. Radiation was strong and hard. My scar was pretty bad. I had D.I.E.P. tram flap. They took fat, skin, and blood vessels from my stomach...no muscle involved so pain was minimal....I have a beautiful breast..I call it my belly boob causebthevskin is from my belly. I gota nice tummy tuck. Because of the radiation the doctor could not use the blood vessels in my chest so he had to reroute the blood vessels in my lymphedema arm to my chest. I am back with my therapist to get my arm back in check and doing well. On my natural breast he will do a lift and implant. This doctor is awesome....this type of reconstruction is notbdobe everywhere but definetly good for those with radiation scars. Life is good.

Re: reconstruction
 

Thank you Candlegranny!!!!

Re: reconstruction
 

Julieta, would it be callous of me to say you look absolutely gorgeous on your pic? I have NEVER (okay, maybe 25 yrs ago....in a one-piece) looked as sexy as you do in your bikini top pic?
My plastic surgeon is kind of a boy wonder genius guy with an awesomely great reputation. I was asking the same question you are asking when I was referred to him by another doctor with the rave reviews.
You will find all my posts here somewhere when I was asking same questions you are right now.

So. I went to him last May. I had finished 30 rads in April.
here is what I learned. By the way I continue to have faith in my excellent Plastic Surgeon.

1. Six months is needed after last radiation as rads continue to work deep inside and might destroy the new breast. (ironically he did mine 5 mos after instead of 6).

2. I asked "diep or tramflap or silicone or salt water or....." and the answer was this:
(which i think is awesome and shows how smart and experienced he is:)

3. "If you look at the research, some recons fail. (result of radiation still working, or infection, or skin being too thin to regenerate after infection...etc etc) Statistically. A Plastic Surgeon has to therefore keep in mind these potential failures which X percentage of the time (twenty? can't recall, but high enough) occur. I have to therefore leave in the future an operation which can be done after the potential failure. In your case, the tramflap or diep...the abdomen muscle etc is an operation I do not wish to COMMENCE reconstructing you with, but is an op i wish to leave on reserve in case the first operation fails. If I start with it, we cannot do the silicone/salt water afterwards. If I start with expander (salt water)/changed up to silicone implant, then afterwards, if that fails, we can always do the diep/tramflap. Not the other way round. If the tramflap is the first operation and fails....you're screwed."

4. By the way, people here like Chrisy? (forgive if wrong) told me you can just leave your expanders in for life and never swap em up for silicone. You do not have to decide before the surgery.

5. My PS (plastic surgeon) did not give me an option (thankfully as he had a brilliant plan to prevent further problems in his head) about choosing the size of implant. He chose an implant on my skin-sparing, non cancerous, alternate breast side HALF THE SIZE OF MY OLD REAL BREAST. On the morning of surgery he was drawing on it, showing the senior resident what kind of wrapping of the silicone implant he was going to do. Turns out he CHOSE THE HALF SIZE IMPLANT so he could double wrap it in skin~. The reason is that if the skin dies off from the frequent post-reconstruction infections that occur, THERE IS STILL ANOTHER WRAP OF SKIN AROUND THE NEW SILICONE!!

So consider asking for a double wrapping of your skin around the new silicone if that is what you are getting.

Also, if choosing skin-sparing on your "good" side, consider nipple sparing too. My nipple, on my non-cancerous side, where i still had a breast, a year after the mastectomy of my cancerous breast, was not aesthetically, at 52 years of age and me being overweight and all something I wished to duplicate. I simply asked the PS what he would recommend, and he said "I will give you far better looking nipples than you had before" so I take him at his word.

Somebody on here recommended a thread on the sadness pre-recon of losing breast sensation, not necessarily as a woman having a sexual partner, but even if you are celibate, the sadness of losing nipple sensation altogether while you sleep ...the sheets giving you nice dreams etc...and that is an excellent thread to read. Yes you will have to grieve that ahead of time, so start that early cos I did and I got that out of the way, and am seriously no longer in any grief about that at all, but you need to go through it before you come out of it i think. the thread can be found on breastcancer.org and you can search "nipples" there. It is completely frank about a taboo topic. helps tho. I am just saying I do not know if by doing a nipple-sparing op on your single existing breast you will have any sensation or not. I was offered one on the morning of my surgery by the surgeon that does the digging out of breast tissue on the good breast. The Plastic Surgeon (the one you go find and meet with several times prior to the operation) is the one I consulted about this offer given by the other.

Re: reconstruction
 

Thank you Norkdo.
You are very helpful.
Tomorrow is the appointment with the PS.


PS; the picture is 2 month before de Dx in 2008. Now I have 30 pound over.

Re: reconstruction
 

please let us all know here how it goes!!

Re: reconstruction
 

My surgeon did a beautiful job in just using expanders then implants, fat transfer and some kind of matrix stuff that provides internal support. 4 weeks later I developed a bad infection between the implant and my chest wall of the radiated side and had to remove the implant. My body just had a tougher time healing there. I am waiting for a few months and believe we will go the flap direction to increase healthy tissue and blood flow. My doc said he has good results trying things the way we did but my research shows the best results for success are using the flap - either belly or back.
Good Luck.

Re: reconstruction
 

Hello Deb.
The dr. told me the best way for me is the diep flap. No implant or expanders.
I'll wait for the next year. It's about deductible.
Thank you Deb :)