Expanders After Mastectomy

I asked a question earlier this week about Radiation and Implants but what I failed to mention is after my Mastectomy expanders were immediately put in and have been expanded since July 2010...I did have radiation on the right side with the expander in. Since it has been slowly expanded over the months even after radiation and my skin is stretched would it still not be a good idea to go with implants?

original question: I was diagnosed with breast cancer in May 2010 at the age of 33. I since have undergone a bi-lateral mastectomy...chemo and radiation. I am scheduled to begin reconstruction in Sept 2011. Due to the radiation on my right side would it be safer to do a DIEP procedure which is what my surgeon wants to do or can I just go with implants which is what I would like to do? Ive been checking up on it and have found alot of sights which say not to put implants in radiated skin

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10 Doctor Answers | Asked by Yvonne in N.M. in Santa Fe N.M

Doctor Answers (10)
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Implant reconstruction after radiotherapy

As you have had expanders for almost a year and have not mentioned any problems, I think it will be very reasonable to have the expanders changed for permanent implants. There are number of known problems that can happen with implants under radiotherpied skin - but they are equally applicable to expanders as well. After all, if you had any major problems with implants in future, there will still be an option for a flap reconstruction. Also, to be fair to your surgeon, DIEP is meant to be... more

Anindya Lahiri, MBBS

4 reviews

Birmingham Plastic Surgeon

Breast reconstruction after radiation with expanders.

There is no right or wrong answers to how to reconstruct the breast after having radiation. As long as you are well informed, you understand the pluses and minuses of having implants vs. your own tissue as a flap, and you have discussed these options in depth with your plastic surgeon then you have to proceed with what you feel is right for you. Both methods have their benefits and risks. The fact that an expander has been placed and has worked without problems is promising... more

Expanders After Mastectomy

Congratulations on achieving a nice expansion in the face of radiation therapy. Sure you can use implants vs a micro flap, it is a decision between you and your chosen PS. Weigh all the options. Best of luck.

Radiotherapy and breast reconstruction

Having had radiation after expansion means you were not expanding irradiated tissues which is good. However, your tissues are now irradiated. So the positive thing is that your skin and muscle may not be as thinned out as they would have been if you tried to expand a previously irradiated chest. However, your next surgery will now be in irradiated tissues that have a poor healing potential. Thus your risk of wound healing problems is still increased relative to... more

Breast reconstruction after radiation

If you have expanders in and have had radiation, reconstruction can certainly be done, but it definitely has higher risks of complications.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Safety of Placing Breast Implants after Radiated Tissue Expanders After Mastectomy

There are no absolutes in Surgery. Whenever a seasoned surgeon hears "always", "never" etc in a clinical presentation, our built-in BS-Pinocchio alarms developed and charged by years of surgical experience and training begin sounding off. We all know that Medicine is an art where based on the set of factors presented to us, using certain treatments would be associated with certain results AND complications. Radiation is very good at keeping cancer from recurring... more

Breast reconstruction with implants after radiation is safe.

Hi. It is not quite as safe as without radiation, but we do it often with very rare problems. And there are plenty of complications with flaps. So, assuming your tissues look healthy, go with implants if that is what you want. It is a lot less surgery.

Radiation and breast implants

Breast reconstruction after radiation is not an all or none issue. It is a statistical problem. SInce tyou already have expanders in, your genral options are replace with an implant (your surgeon can review risks of capsular contructure using saline or silicone implants), autogenous reconstruction with the various flap options, or a combination using implants and a latissimus flap. Each patient's treatment must be individualized taking into all the considerations of past history, past... more

Robin T.W. Yuan, MD

4 reviews

Beverly Hills Plastic Surgeon

Breast reconstruction with expanders if having radiation?

Yvonne, this additional history is very important. Immediate breast reconstruction with tissue expanders is safe. Sometimes the patient may require radiation after the mastectomy and reconstruction. This does increase the risk of complications with the expander, but many patients do well. If you have done well with the expanders and are happy with the result and expansion so far, you can simply have an expander exchange for a permanent silicone implant. The risk of infection or wound healing... more

Place implants.

That does change things! If the expansion has been completed and is large enough, I would place the implants with the understanding that the complication rate, particularly capsular contracture, is higher. If your tissue is adequate, I would probably use saline.