Age 71, 138lbs, will replacing implant post radiation lead to problems?

Question

Almost 15 y ago I had a mastectomy on my right breast w implants to both breasts. I recently had a recurrence on the rt breast and underwent chemo and radiation. As a result, the breast has now shrunk and is harder. I also occasionally get pains in that breast. I went for a consult with a local plastic surgeon and was told any tampering with a radiated breast can lead to a host of problems. Is this true? I would like to replace my breasts with smaller implants. I'm 71, 138 lbs

David Branch, MD · Answer

Helpful775146, how old are your implants and or have you had them exchanged? Are they gel or saline? If you have aged gel implants it would be important to know if you have an implant rupture. If you have a rupture then removal of your capsule(s) is necessary. Either way, it is probably ok to decrease the size, but it is important to assess the skin to make sure it is not too fibrotic or tight. Fat grafting or shifting to the right breast may improve the skin quality after radiation.

Tommaso Addona, MD · Answer

Thank you for your question.
Without photos and limited information, it is difficult to say where the cause of your discomfort is coming from. In my experience, I usually will not operate on a patient until they are six months out from their last radiation. I would recommend you speak with a plastic surgeon to discuss your concerns and for thorough evaluation.

John Michael Thomassen, MD · Answer

Risks of implant reconstruction in setting of breast radiation has a high complication rate including infection, extrusion, and capsular contracture.  It may be beneficial to consider using autologous tissue transfer for reconstruction where a patient uses their own tissue to reconstruct the breast.  However, if you have implants in place and it is a simple exchange of implants for a smaller size, this may not be as risky a procedure.  It is best to have an in person evaluation.

Daniel Barrett, MD · Answer

Dear Helpful775146,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Kelly Killeen, MD, FACS · Answer

Radiation can certainly be problematic with implants, and with healing in general.  Although there are more complications with operating following radiation, it can be done safely with some modifications and special care after surgery.  Living with a hard, painful breast isn't fair to any patient and there are certainly options to treat this for you.  I would recommend consultation with a plastic surgeon who is experienced with post-radiation patients like yourself to get the best results.  Good luck!

Darryl J. Blinski, MD · Answer

Without posting photos impossible to offer accurate assessment. Try more in person opinions or virtual consultations. Understand very few senior boarded PSs accept or participate in MediCare. As for doing surgery isa radiated contracted reconstructed breasts the changes of implant infections and reoccurring capsule formation are very high.

Age 71, 138lbs, will replacing implant post radiation lead to problems?

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