Radiation Treatment Effects on Silicone Implants?

Question

I'll be having a lumpectomy and I have concerns about the silicone implants I already have. My surgeon said that I will need radiation every 5 days for 5 to 6 weeks. How will it affect my implants?  I have had the implants for almost 2 years now.

Darrick E. Antell, MD, FACS · Answer

I have had patients in similar situations and frankly do not recall any of them needing revision surgery. While each patient reacts differently, and while some of my patients did develop mild firmness of the breast, none of them was so severe that surgery was necessary.

	The radiation will not affect the implants themselves, it's the scar tissue around the impant (the capsule) and adjacent tissues that can be affected. Regardless, I would proceed with your current treatment plan and try to stay optimistic. Frankly, I doubt that any revision will be needed but you can cross that bridge when you come to it. Your implants have been in a sufficiently long time (2 years) that you have healed and in select patients with scars on other parts of the body, I have removed the scar and sent the patient for radiation treatment to minimize scar formation. Wait and see; time will tell.

Steven Wallach, MD · Answer

Radiation may cause a capsular contracture around your implants. This can happen when reconstructions are done in patients that have mastectomy and get RT as well.

John P. Di Saia, MD · Answer

Hello,
The implants will probably not change much from the radiation per se as they seem pretty new (2 years old.) The radiation may encourage the development of hardening (capsular contracture), however. Hopefully if this happens it will be mild.

Scott E. Kasden, MD, FACS · Answer

Radiation protocols have changed over the years, and are safer today than ever.  However, radiation is not good for healthy tissues. The most likely risk to your implants is not the implants, but the scar tissue around the implants. Radiation will increase your risk of capsular contracture. I don't know specific percentages, but there is a fair chance that you may see this in your future.
Don't fret about it. The main thing is to get healthy from the cancer. If you get a contracture, it can be treated later on.
Best of luck to you.

Robert S. Houser, DO · Answer

The radiation doesn't affect the implant per se, but it does affect the capsule, remaining breast tissue and the skin. I perform a lot of breast reconstruction as well as cosmetic augmentation and depending on your age, you may want to consider completion mastectomy with immediate implant reconstruction to avoid the radiation. At least know that it is an option. With radiation, the affects are often not immediately noticed. I have had dozens of women get through the 6 weeks of radiation with nothing more than a dark tan, only to develop a tight contracture 5 months later. The use of radiation now may also limit your reconstructive options in the future should there be a need for (I certainly hope not) a mastectomy in the future. Unfortunately, the radiation oncologist may not be the most informed person to speak with either because they are often unaware of the long-term impact of the radiation on the aesthetic appearance of the breast. I would encourage you to either see your original plastic surgeon or another in your area who does a fair amount of breast reconstruction to review your options. Time is of the essence and I certainly wouldn't want you to delay your cancer treatment, but you do have options. Good luck!

Robin T.W. Yuan, MD · Answer

Radiation therapy is frequently the companion to lumpectomy in treating breast cancer. It does however raise the possibility of complication with implants, most commonly capsular contracture or hardening. If this is avoided or is mild, then you may do okay. Significant patients do have on-oing problems fighting the hardness and trying to get both breast to look and feel symmetric.
Although the usual instinct and political correctness is to elect conservative surgery such as lumpectomy, you may be a patient for whom this is not the best treatment because of the radiation/implant problem. In women who are very small to begin with and who undergo cosmetic breast augmentation, their situation is not too dissimilar from patients with post-mastectomy reconstruction, albeit with the nipple. Each of these patient has breast mainly composed of implant and skin. You should discuss the ramification, advantages, and disadvantages of possible mastectomy using a skin-sparing technique. While this may require relatively more surgery, this may be more than offset by the ability to avoid radiation therapy. I would urge you to seek out a board-certified plastic surgeon with experience in breast reconstruction. There are many ways to reconstruction the nipple areola complex and you may end up with a very aesthetic and natural result without the side effects associated with radiation. Please contact me if you would like a summary of a plastic surgeon's role in treating breast cancer.

Francisco Canales, MD · Answer

Hello 
Sorry to hear about your lumpectomy and possible radiation, but it sounds like your lump was caught early.  In general, radiation can lead to firmness of any tissue, whether you have implants or not.  With implants in place, there is a fairly high chance that you will develop some firmness of the implant. It may have some effect on the cosmetic result, but, obviously your health demands that radiation take place.  Ask both the surgeon and the radiation oncologist if there are ways to minimize firmness in the radiated breast.  I am not aware of any, but it does not hurt to ask.  Best of luck.

Richard P. Rand, MD, FACS (retired) · Answer

Your health and the treatment of your breast cancer comes first of course. However, it is good to know that there is an increased risk of capsular contracture around your implants after radiation. Only time will tell if this will happen to you. Good luck!

George J. Beraka, MD (retired) · Answer

To Bonniet,
Hi.  You are in a fairly common situation, and most women do well.
First, your surgeon needs to be sure that the lumpectomy can be done without risk to the implant, and without deforming the breast.  Otherwise,  you should have a plastic surgeon available.
After radiation, capsular contracture (tightening of the internal lining around the implant) can develop, and this causes some firmness of the implant.  Slight firmness is more common, and you can live with this.  If the breast gets really hard, you may need more surgery in the future.
But be optimistic and don't worry about this now.  You really need the lumpectomy and radiation, so there is no choice.

Radiation Treatment Effects on Silicone Implants?

Answers (9)

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