I've had a left side mastectomy and lymph removal. Post radiotherapy (feb 2013) the port of my tissue expander was infected with staph aureus and removed. The infection returned. I've been advised to have the expander out and leave it for 3 months before attempting reconstruction. What will happen to the skin that is left? I'd like to avoid flap surgery as I'm very slim and it's major surgery. What are the chances of the skin surviving 3 mths for another expander and implant rather than flaps?
Post Radiotherapy my Tissue Expander Became Infected. Will the Skin Survive to Stretch for Another Expander/implant?
Doctor Answers (2)
Infected expander in radiated tissue....
leaves you with few choices except to remove your expander and allow yourself to heal and recover from your infection. Is 3 months adequate? No one can guarantee that as many wait 6 months before returning to attempt another reconstruction. Ideally, you would use autogenous methods under your circumstances. However, you can still choose to attempt another try with expanders, especially if you do not want the additional scars from using your own tissue and are prepared for failure, as it certainly could happen and don't desire to be very large.
Once the expander is infected it has to be removed, treat the infection. The skin will retract and swelling will remain with you for a long time because of the infection and radiation.
In the face of radiation , history of infection , most implant reconstruction will fail, or atleast will have multiple complications.
In the face of radiation flap reconstruction is the standard.
The other alternative in the face of radiation and infection is Latismus Dorsi myocuateous flap with or without implant, if one has to use an implant.
The Laismus muscle will bring in new blood suply and good coverage for the implant.
I know the insurance will not pay much for the flap but the plastic surgeon needs to be the advocate for patient safety and what is best for the patient not the insurance co. or the $$$$
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.
You might also like...
Ask a Doctor
Get personalized answers from board-certified doctors. For free.