Have you replaced implants after radio? What's your experience/issues/advice +capsule (kept /rem'd)?

MazT Member Posts: 7

I'm in discussions with two surgeons (initial and then second opinion) about removing my 10-year-old textured and radiated implants and either going flat or replacing implants. I posed a similar question on the reconstruction group - I'm hoping this main chat has some people who have faced re-reconstruction.

I was first diagnosed with BC in 2011 and had a loco-regional recurrence in 2014. I had a mastectomy with immediate reconstruction in 2011 (39 years old), and the other side was prophylactically done a year later. Due to the recurrence, I had radiation to the implant reconstructed site (10 years ago). The implants are the textured variety. The radiated side has some contracture (firm/tight), but specialists have told me it's not too bad (but it feels average to me). I also have a fair amount of tight scar tissue under my arm due to the recurrence and radiation.

I'm so confused because two surgeons have advised different processes for removing the current implants.

One of the surgeons has suggested that due to the radiated skin and existing scar tissue,  I have up to 50%  chance of failure of replacing implants, resulting in needing a flap reconstruction or going flat. This has frightened the life out of me because I thought the replacement surgery would be relatively minor (a simple grease and oil change LOL)

This surgeon suggests removing as much of the scar tissue capsule around the implant as possible before inserting the new implant (but not because of breast Implant Illness concerns - neither surgeon is on the en bloc/ BII train). Removing the radiated capsule could remove the current hardness and minor deformity. This surgeon also advises I may need up to 3 fat sculpting surgeries to smooth out the breast (thin) skin (but that’s more general anaesthetics and recovery and $s!).

The other surgeon suggests leaving the capsule as is and placing the new implant inside the existing capsule. As my skin is very thin from the mastectomy, removing the capsule could hinder healing and create more scar tissue/infection/concaving. The fact that this area is radiated means the newly created scar tissue capsule could be worse than the one removed. I guess this approach means the existing firmness stays – but hopefully, it shouldn’t get worse if it heals without infection (better the devil, you know?).

If you replaced your implants after radiation, what has been your experience, scars, issues and advice? 

Did your surgeon remove or keep your existing capsule?