I have capsular contracture due to radiation and need a revision to reconstructed breasts after breast cancer. I've had consults with two different plastic surgeons and have two different opinions. In one consult, the surgeon suggested I have silicone implants with neoform along with lipofilling if needed. The other surgeon says this is not possible due to the radiated breast. I need to simply replace the implants to get rid of capsular contracture. (I originally had tissue expanders and very little, if any, tissue left in breasts after mastectomy)
Can Neoform Be Used over Breast Implants After Radiation?
Doctor Answers 5
Correcting a Capsular Contracture in Radiated Reconstructed Breasts
You have two challenging problems which together pose a serious Plastic surgery challenge. Capsular contracture and a Radiated breast.
From your description, I agree with the opinion of your first Plastic surgeon. All capsular contractures by definition must completely surround the implant 360 degrees. To break this choke hold a large part of the capsule must be removed and hopefully stopped from recurring. Removing the scar tissue and replacing the inferior/side wall with AlloDerm ( a human dermal matrix) has been shown in several studies to prevent onset of new scarring. In addition, it will keep the implant from sagging AND provide a thicker cover which will better hide the implant ripples. Adding fat grafts just under the skin will hide many of the ripples and give the skin a fresher more youthful look. I believe this is a better option than just removing the scar capsule which invariably will return.
Radiation and capsular contracture
If you have a irradiated breast after reconstruction and a capsule, you may need alternative reconstrucion to be performed. Alloderm has been used in capsules to help post-op but alterntive reconstruction depending upon how the skin looks may be necessary as well.
Plastic Surgeon #1 has the best surgical approach outlined for you. Radiation affects all the tissues and a recurrent capsular contracture could happen.
Good luck !
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Dermal Matrix and radiated breast
Even in an irradiated field, you still can utilize Neoform or any of the other dermal matrix products (Alloderm, Strattice, Flex HD). The goal in using these in your situation would be to get rid of the inferior capsule and replace it with the Neoform. In some situations, this can help prevent some contracture around the new implant. There is a risk, though, that because of the radiation the Neoform will not be incorporated into your tissues as easily as it does in a non-irradiated breast.
Neoform in breast reconstruction
I would follow PS #1 advise in reconstructing your capsular fibrosed breasts. Sounds to me he has offered you a good plan to correct your issues.
From MIAMI Dr. B
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