Is Scar Tissue Removal Possible After Breast Implant Reconstruction and Radiation?

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?

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4 Doctor Answers | Asked by papillon01 in CA

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Capsular contracture post radiation

Dear Papillon01, Sorry to hear about your current result. One of the problems is we really do not have a complete understanding of capsular contracture. After mastectomy there is often a paucity of skin thickness. There are options of revision by capsulectomy and addition of acellular dermal matrix which has been a God send in treatment. Results can be good and recovery usually uneventful. Another option is the use of your own tissues to replace an implant. This can be done as a first... more

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... more

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.

Breast Reconstruction

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. more