First, I admit that my bias is strongly toward under the muscle for implants.
That said, you have had a mastectomy, and there is NO breast tissue to cover the implant. I would estimate that if you could find someone to put the implant under the SKIN, you would have ~100% chance of a complication.
In your curent situation, you are likely experiencing a contracture. You will always be at some increased risk for contracture due to the radiation and mastectomy. As I see it, you have several choices, and the luxury of time to make them. #1, do nothing for now. #2 Remove the implants and leave them out. #3. Get a capsulectomy and replace the implant, with possibly a textured surface implant. #4 bring in your own tissue for a reconstruction, and this could include a TRAM flap (from your tummy), or a Latissimus Dorsi Flap (from the sides).
Whatever you decide, this is a good time to initiate a visit with your ps to get a plan going.
Best luck to you.
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