I had tissue expander reconstruction almost fully inflated, but didn't need radiotherapy . I also know of a lady who had this done pre radiotherapy. Sometimes the scarring can make the pocket tight so they can clear that out after radiotherapy when changeover happens so the pocket and implant are soft. The changeover was super easy and not at all lie 1st surgery. 48 hours in hospital though for antibiotics to reduce infection risk, but that's it. The 1st surgery is hard going and takes about 6 weeks to recover.