Failed Breast Reconstruction w/ Implant. Try Again?

Given the fact you have had irradiation of the breast and chest in the past makes you more risky to have an implant based reconstruction. 

Thank you for this great question and hope that all of these answers will assist you in your decision.  Attempted implant-based reconstruction after radiation to the breast typically have a higher complication rate with a significant failure rate.  Complications, include, infection, wound complications, capsular contracture, and implant exposure/failure of expansion.  There are some very notable papers that have described adequate results with implant-based reconstruction in the setting of an irradiated breast, and so, it is not unreasonable to attempt this again, knowing that there is a significant chance, however, that it may fail again, especially given your previous experience.  

 

Flap-based reconstruction would be the wisest choice to consider, which would bring in well-vascularized tissue from a remote area of your body, thus ameliorating the damage that radiation has caused.  With the options for microsurgical, perforator flap breast reconstruction today, the minimal morbidity and functional deficits of these muscle-sparing procedures make them very attractive for women like yourself.  The DIEP or SGAP flaps are excellent choices for breast reconstruction using your own tissue, without the need for an implant.  Finding a plastic surgeon experienced with performing microsurgical breast reconstruction and discussing this option may be worthwhile.  

i would be very hesitant to try a tissue expander again in your situation.  what has changed to make you feel that the same operation would work  this time.  i agree with bringing in your own non-radiated tissue into this region to help  with the reconstruction. your back, tummy or buttock are all apprpriate donor sites.  but please go for it! t

I am sorry to hear about your ordeal, but I am sure there are options. It will be more difficult however because of scar tissue from the previous surgery and the radiation. I have had success using Alloderm with implant reconstruction after radiation. In the DC area you may wish to see Dr. Nahabedian or Dr Spear. 

Hello Stephanie,
I believe you have many options for reconstruction. I would advise you to fill out the BRA score and see what your risks are for each type of reconstruction. This may help you make a decision along with your plastic surgeons recommendation. Good Luck!