Will my implants fail because my skin is radiated?

I had a mastectomy on left breast in July 2015 with tissue expander put in at time of surgery. 4 months of chemo followed by 25 rounds of radiation. I finished radiation in beginning of February 2016. I read that implants almost always fail after your skin is radiated. I was also thinking of having my right breast taken off. I feel that it will be a waste to do implant exchange and another implant on right if one is going to fail but I am young (49) and do want to reconstruct. Help!

Doctor Answers 7

Implants after Radiation

Thanks for your question.Radiation can be associated with a very high risk for implant use.However, things have gotten better due to the use of fat grafting and ADM (Acellular Dermal Matrix) in reconstruction.However if the wound is healing well and there is no complication, I would still not to do anything about it.If something happens, then a flap might be another option.


Orange County Plastic Surgeon
5.0 out of 5 stars 19 reviews

Radiation and breast implants

It is true that there is a higher rate of breast implant related complications if you have radiotherapy, either before or after your implant.  But that doesn't mean it can't be done and just because you had radiotherapy it doesn't necessarily mean you will have a problem.

If you are considering another mastectomy then it is a very good question whether or not you should proceed with an implant exchange for the irradiated breast or have a tissue reconstruction.

It is not a simple answer and one that is impossible to give without a consultation.  

Evidence suggests that most patients who replace an irradiated tissue expander with a tissue reconstruction (such as a DIEP flap), rather than an implant,  will have a better outcome in the long term with less complications and operations over their lifetime.

I suggest you discuss with your breast and plastic surgeons your plans regarding mastectomy and reconstruction and make a well informed choice.  There is no need to rush into another operation at this stage and allowing time to heal is a good idea.

All the best with your future surgery.

Kind regards,

Dean

Implants and radiation

The rates of complications in the presence of radiation definitely are higher, but there are several studies showing success with implants alone.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Implants and Radiation

Thank you for your excellent question.  There is certainly a higher risk of complications in a radiated breast, but permanent implants can still be used successfully.  Your choice of implant versus autologous reconstruction depends on the specifics of your situation and your goals and expectations.  A very nice result can be obtained.  Please be sure to stay in close contact with your plastic surgeon, who can best answer your questions and help you to determine the best course of action.  Best wishes! 

Implants and Radiation

Thanks for sharing your question.  Implant reconstruction in a radiated field carries a higher risk of complications (Infection, Displacement, Contracture, Extrusion, etc...) This doesn't mean that it can't be done, but you are looking at the potential of complications and dissatisfying results.  In the radiated breast, autologous reconstruction works best.

Ali Sadeghi, MD, FACS
New Orleans Plastic Surgeon
4.8 out of 5 stars 20 reviews

Radiation and breast reconstruction

Thank you for your question.

Radiation can complicate an implant-based reconstruction. That being said, implants can be used in the setting of radiation, too. Several centers and research studies have shown implants can be used with radiation, understanding that the cosmetic outcome may be suboptimal and complications may be higher. If you implants fail, there are other methods to reconstruct your breasts, such as using your own tissue. There are several different options to use your own tissue to reconstruct a breast.

Good luck on your journey!

Regards,

Manish C. Champaneria, MD

Reconstruction with implants and radiotherapy

Dear Mich9193,

I am sorry to hear about your diagnosis and I hope that you have coped with the surgery/ chemotherapy and radiotherapy.

It is true that there is an increased risk of complications with expanders/implants after radiotherapy but it is not definite that the reconstruction will "fail". Recent studies put the risk of major complications of radiotherapy to implant based reconstruction at around 40% - which is high - but still less than half.

If you are considering having a mastectomy and reconstruction on the right side, given that you have had an implant based reconstruction on the left, for the sake of symmetry, I would suggest you try for placement of either an expander or even straight to implant on the right side at the time of exchange.

The other thing to remember is that there are other forms of reconstruction you can have, even if the worst happens with the left breast reconstruction. Tissue can be moved from other parts of the body - either in combination with an implant or just using your own tissue alone - to reconstruct a breast. If you are considering a right mastectomy, I think it is important to use the same technique - whatever that may be - for both sides.

Please discuss all these concerns you have with your plastic surgeon and they will be best able to advise you about the risks specific to your case.

I hope this helps.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.