Radiation

Thanks so much for the update.  I do have appointments in the next month with two plastic surgeons, I definately want to gather all the information I can.  I am an American citizen as well and have good health insurance in the USA.  So I'll be seeing some surgeons there later in the year.  Nothing like making things just that little more complicated.

Anna

Thanks so much for the update.  I do have appointments in the next month with two plastic surgeons, I definately want to gather all the information I can.  I am an American citizen as well and have good health insurance in the USA.  So I'll be seeing some surgeons there later in the year.  Nothing like making things just that little more complicated.

Anna

Anna, I am going along well at the moment. I have signed papers for the next lot of fat transfer (via liposuction) after the middle of May. Not sure if you've read my posts in the Reconstruction group but to recap. On the way into surgery to replace the implant the surgeon said he had added lipo to the papers in case he needed to do some to plumping around the implant. Which he did. Because there is quite a size discrepency between my breasts now, even more than before, he is going to try & even them up with the fat transfer between the muscle & the skin around the implant. Especially where the inframammary fold should be. Mine is about an inch & a half higher than the other side which is making my bra slip up, very uncomfortable !  The ultimate answer would be a flap recon, but they need to sort my autoimmune system out a bit first. Hopefully if this implant goes wrong I will be in a good enough spot to have the flap done. Now I just keep an eye to see what happens.

If I were you I would be starting to look at what you might do in regard to recon, it could take a while to have it done if you go public. At least talk about it & reseach what will be best for you/what you are comfortable doing. Don't hesitate to keep asking questions.

Carmel

Anna, I am going along well at the moment. I have signed papers for the next lot of fat transfer (via liposuction) after the middle of May. Not sure if you've read my posts in the Reconstruction group but to recap. On the way into surgery to replace the implant the surgeon said he had added lipo to the papers in case he needed to do some to plumping around the implant. Which he did. Because there is quite a size discrepency between my breasts now, even more than before, he is going to try & even them up with the fat transfer between the muscle & the skin around the implant. Especially where the inframammary fold should be. Mine is about an inch & a half higher than the other side which is making my bra slip up, very uncomfortable !  The ultimate answer would be a flap recon, but they need to sort my autoimmune system out a bit first. Hopefully if this implant goes wrong I will be in a good enough spot to have the flap done. Now I just keep an eye to see what happens.

If I were you I would be starting to look at what you might do in regard to recon, it could take a while to have it done if you go public. At least talk about it & reseach what will be best for you/what you are comfortable doing. Don't hesitate to keep asking questions.

Carmel

Ladies - I've been thinking about how you're going.  I recently had an appointment with my radiation oncologist.  As you might remember I haven't had any reconstruction yet and I'm having a lot of discomfort with fibrosis (scaring) and cording on my right side.  When discussing this the Rad Onc. said that radiated tissue will continue to contract and I'll always need to be diligent with stretches etc.  Also she implied that I should perhaps consider reconstruction, which would be a Diep or tram flap, sooner rather than later.  Apparently as the radiated tissue will only become more fibrotic over time.  So so much for waiting for contraction to 'finish'.  Obviously it will never finish.

Anna

Anna/Peta. I had immediate skin sparing mastectomy with implant recon.....no flap. I was about an E before surgery & the surgeon used the biggest implant he could to try & keep some symmetry. (mx side was bigger so she needed to come down a bit anyway). Radiation wasn't on the cards until about 1/2 way through chemo, so that came as a bit of a shock because I had the recon based on the fact that I wasn't likely to have rads. So my implant was radiated. Its not actually the implant thats the problem, its the muscle/scar capsule that is the problem. After rads the muscle & scar capsule slowly contracted over about 12-18 months (as your onc says)it started about six months after rads. I pushed the replacement back as far as I could to try to get to two years past rads (actually its two years today) & had the surgery nearly four weeks ago. Possibly that is why surgeon has pushed back exchanging expander so far ??( not necessarily a bad thing !)  or (Anna) waiting for about two years could be a good decision too........

Happy to answer any questions if I can.

Carmel

Anna/Peta. I had immediate skin sparing mastectomy with implant recon.....no flap. I was about an E before surgery & the surgeon used the biggest implant he could to try & keep some symmetry. (mx side was bigger so she needed to come down a bit anyway). Radiation wasn't on the cards until about 1/2 way through chemo, so that came as a bit of a shock because I had the recon based on the fact that I wasn't likely to have rads. So my implant was radiated. Its not actually the implant thats the problem, its the muscle/scar capsule that is the problem. After rads the muscle & scar capsule slowly contracted over about 12-18 months (as your onc says)it started about six months after rads. I pushed the replacement back as far as I could to try to get to two years past rads (actually its two years today) & had the surgery nearly four weeks ago. Possibly that is why surgeon has pushed back exchanging expander so far ??( not necessarily a bad thing !)  or (Anna) waiting for about two years could be a good decision too........

Happy to answer any questions if I can.

Carmel

Peta and Carmel,  Thanks for your feedback.  I hope we get some more input as post radiation effects can be an issue and I haven't been able to get much clear, honest information on what others have experienced.

As yet I am not looking at reconstruction but I feel I will wait until the 2 year mark.

Thanks so much Anna

Hi Carmel,

Thanks so much for your post and I hope you can help me with my questions below. First some background... I recently completed radiation on one breast with a saline-filled expander. I knew I would have to wait at least 6 months post radiation to allow tissue to settle before a 'proper' reconstruction. I was caught by surprise when my radiation oncologist mentioned near the end of my treatment that contraction typically occcurs at the 12-18 month mark. I am now wondering whether I should postpone reconstruction surgery for 18 months - which does come at an emotional cost given the current glaring mis-match in the shape and size of my breasts (my plastic surgeon inflated the expander to its maximum size - presumably to allow for radiation contraction).

My question is how many months elapsed between your initial implant surgery (I'm assuming done in conjunction with a mastectomy) and the on-set of contraction? Did you have a DIEP flap or TRAM flap? Reason for my question being that I lost a lot of weight after my diagnosis mid-last year and can't see that I have enough abdominal fat and tissue for either, but my radiation oncologist is not keen on implants -presumably to avoid the complications you've described.So I'm feeling caught between a rock and a hard place! Although my decision can wait a few months, I'd really appreciate the your insights from personal experience.

Kind regards,

Peta

 

 

 

 

 

 

Anna, I hate to be the bearer of bad news but contracture doesn't "un-contract". I have just had my breast implant replaced due to contracture & am keeping my fingers crossed that I waited long enough (2 years) since I finished rads that it has stopped. Time will tell. Not sure what can be done in your case. Mine was operated on because of the pain it was causing, replacement implant is much smaller than original so hoping this helps.

Carmel