Last year I had a mastectomy due to multiple malignant phyllodes tumors. Immediate implant reconstruction surgery took place. I underwent 31 days of radiation therapy. Now, I am experiencing sharp, deep pain, and extreme rigidity. I have been informed by my plastic surgeon that I am experiencing capsular contraction, and because radiation further compromises the remaining tissue, is it impossible to remove the capsule. Is this true, or is their hope? If so, are there experts in this area?
Is Scar Tissue Removal Possible After Breast Implant Reconstruction and Radiation?
Doctor Answers (5)
Capsular contracture post radiation
Reconstruction following radiation is still possible
Most patients who have your history of reconstruction followed by radiation have the same story of hard capsules and painful symptoms. These can be treated best by changing the reconstruction type--to either a latissimus dorsi flap or another autogenous reconstruction--made with your own tissues. The flaps add circulation and greatly improve the reconstructive result and the symptoms.
These are standard plastic surgical problems--you only need do find an experienced breast reconstructive surgeon whom you like.
Radiation therapy and breast implants not a good combination
The incidence of capsular contracture with radiation therapy to breasts with implants is very high as you unfortunately can attest. Your options are very limited because of the changes to the tissue caused by radiation, but there is some evidence that removing the scar capsule (capsulectomy) and using Alloderm grafts can be helpful.
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Is scar tissue removal possible after breast implant reconstruction and radiation?
If you are willing to continue with your current implant reconstruction, capsulectomy and implant replacement is a fine plan. However, there is always the possibility of the scar and contracture to return, at which time, your options will be those above again. If after this time, you should consider a flap reconstruction. It is not impossible to remove the scar/capsule, but, unfortunately, in the face of radiation, the issue will continue to develop. Consult with your plastic surgeon to discuss the various options and what will be the right decision for you. Best wishes!
The capsule can probably be removed, but you will likely not be able to put another implant in the same place without the same risks. Radiation changes all the rules, and scar tissue is so much more common, and devastating to the implant pocket. Follow closely the advice of your surgeon and if they recommend removal or keeping them in place, follow the advice. These cases are so individual, only an experienced eye for reconstruction can give the best advice.