How Long After the Healing Can I Redo Reconstruction? Which One Will Be Better in my Case? (photo)

Due to breast cancer i had a mastectomy in 2010 and radiation in 2011. Two months after radiation i did reconstruction with implant and got infected. My doctor had to remove the implant and now i am using a wound vac.

Doctor Answers (7)

Radiation

+1

If you have enough abdominal tissue or inner thigh tissue this can be performed now. I don't like to hear that you don't have a breast reconstruction and you have a wound to deal with.


Austin Plastic Surgeon
5.0 out of 5 stars 7 reviews

Delayed Breast Reconstruction with a DIEP flap

+1

Unfortunately, implant reconstructions do not work out well with radiated breasts.   I am sorry to hear of your delay in wound healing.

 

Once your wound is clean and healing, I would recommend using your own tissue to reconstruct your breast.   Options include abdominal tissue (DIEP flap), buttock tissue (S-GAP), or upper back tissue (latissimus dorsi). 

 

In radiation, blood supply to the breast skin is drastically reduced, which leads to infection and wound healing problems.   By using your own tissue, your plastic surgeon can remove the majority of this radiated tissue and replace it with healthy, well vascularized tissue.    

In the longterm, this will lead to a more natural feeling and looking reconstruction.  I wish you a safe recovery!!!

 

Dr. Gill

Paul S. Gill, MD
Houston Plastic Surgeon
5.0 out of 5 stars 34 reviews

Healing a wound following radiation.

+1

A radiated wound can take several months to heal. Unfortunately, if the breast skin is not held out to shape prior to and during the radiation, implant reconstructions have a high complication and failure rate. The use of tissue flaps to replace the irradiated skin are preferred. A wound vac will help close the wound, however an implant reconstruction following wound closure will be difficult due to the presence of a large amount of scar formation and the irradiated nature of the tissue. I would recommend waiting at least 6 months following wound closure before addressing the reconstruction options.

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 8 reviews

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Reconstruction after Radiation and Implant extrusion

+1

I'm sorry to hear about your experience.  I generally wait 6-12 months after radiation therapy before proceeding with delayed reconstruction.   It takes this much time to allow the radiation inflammatory effects to "cool" off.   Now, given your wound, you should consider autologous reconstruction (using your own tissue without an implant).  Please see a board certified PS to see if you are a good candidate for delayed reconstruction using your own tissue with a procedure such as a DIEP or TRAM flap.  Best of luck.

Dr. Basu

Houston, TX

C. Bob Basu, MD, FACS
Houston Plastic Surgeon
4.5 out of 5 stars 114 reviews

Revision breast reconstruction after radiation

+1

You will have to wait until full healing takes place.

At this stage you will need to be reassessed

Although flap reconstruction is recommended in this situation, there are other options

The tissues can be considerably softened with PRP and fat derived stem cell injections.This may even be all that you need

Once the tissues are pliable ,expansion is often possible

Hilton Becker, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 5 reviews

How Long After the Healing Can I Redo Reconstruction? Which One Will Be Better in my Case?

+1

Thanks for the question and posting a photo. First thing first, allow FULL healing and maturation of the area. That could take a year. I recommend hyperbaric O2 therapy plus PRP injections to the site to stimulate healing. After things settle down determine a flap type reconstruction using autologous tissue. Best to you.  

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 61 reviews

Wait for complete healing then 3-6 months

+1

Sorry about the complication you suffered after going through breast cancer and radiation plus reconstruction.  Unfortunately this is a complication not uncommon with radiation and implant reconstruction.  Certainly I would wait until at least 3 and probably 6 months after healing.  In all liklihood you will need a diferent type of reconstruction such as a TRAM flap or DIEP flap.  I would wait until you are healed to go see several doctors who do this type of surgery.  Good luck and a speedy recovery. Dr. Schuster in Boca Raton

Steven Schuster, MD
Boca Raton Plastic Surgeon
4.5 out of 5 stars 3 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.