Implant reconstructive after radiation?

Hi Everyone, 

I am almost 6 months post radiation & have an upcoming appointment with plastic surgeon re reconstruction. 

He previously recommended a Diep flap reconstruction (due to radiation) with fat from my stomach & I expressed agreement/interest in having this type of reconstruction. 

However now, although not scared of surgery, I'm having doubts as the recovery seems quite long & intense.

I am not carrying that much weight as a size 10/12, so it's not like I even want the side effect of a tighter tummy & conversely the surgeon already said he won't be able to create a breast even as big as my original (small C cup) breast

The diep 8 hour surgery involves a hip to hip incision etc with weeks of recovery. I love being active & live alone, so I feel an implant reconstruction ( small C cup!) would suit me better. Yet perhaps my surgeon will not be prepared to do it? Has anyone out there had an implant reconstruction post radiation? 

My skin there looks okay although still a little tender & slightly red under my armpit, so maybe I am dreaming of a straightforward implant surgery!

Thanks so much for reading X

  • Hi [@Jane83]‍ 

    It sounds like you've put a lot of thought into your upcoming surgery. I'm sure you've got a long list of questions to ask the plastic surgeon when you do go for your appointment.

    If you haven't already written down your concerns, queries and questions then maybe do that ahead of your meeting. That way you'll be able to go through everything and hopefully it'll help you make a decision about which way forward you feel is best. 

    You've probably have already read most of this information but I wanted to give you the link to the page on our website about breast reconstruction just incase there was anything additional there that may help. 

    I've also had a look through the forum and found some members who have had reconstruction (athough not post radiotherapy). [@Pringle68]‍ and [@shortcake74]‍ have both had Diep reconstruction. [@amandajane25]‍ and [@TwinTwo]‍ have both had impants. As I've tagged them into the reply here, hopefully they'll be able to share their experiences of surgery and recovery with you.

    I also wondered if you might find it helpful to have a chat with your breast care nurse ahead of your reconstruction appointment. It's possible that she may be able to tell you if an implant is an option given that your skin is still a little tender. Or that maybe waiting a bit longer for things to settle might be something you could consider. 

    Lots of questions! But I hope that the ladies who have some first hand experience will be along before too long and share their words of wisdom with you. 

    Best wishes, 
    Jenn
    Cancer Chat moderator

  • I had DIEP reconstructuon yesterday. So far so good..it looks good and on morphine for pain relief. I ll let you know how I get on x

  • Hi Pringle,

    Great to hear you are happy with the Diep result! 

    The abdominal part of the surgery & the length of recovery does make me a little cautious. Thank you so much for posting, especially as you are only just out of surgery X

  • Thanks to [@Moderator Jenn]‍ for tagging me.  Sadly I'm not on here much just now as my chemo is playing havoc with my eyesight causing nausea headaches when I read or write.  Only 1 cycle to go though :)

    I haven't had a reconstruction post-radiotherapy, but according to every surgeon I've met it's better post than pre as radiotherapy can harm the reconstruction.  So doing it after is working in your favour.

    I am also a size 10, but 12 on the chest (5'5").  They couldn't do a DIEP on me as they said I didn't have enough fat for one breast never mind two (the plan was always to do the non-cancerous breast at some point).  So I have a fixed implant.  I can honestly say I had absolutely no problems from the reconstruction surgery itself.  The seroma (fluid swelling) I experienced for a few months afterwards was because I'd had an axillary lymph node clearance at the same time as the mastectomy and reconstruction, it wasn't down to the reconstruction itself.  I had very little pain, just some discomfort where the drains had gone in, and that cleared in under a fortnight and it was never constant anyway, just a twinge when I made certain movements.  My sleep was affected as I had to sleep on my back whereas I usually move around a lot at night, so allow for some sleep problems at first.  But within days I was back to normal tasks, taking care not to do anything that involved heavy lifting or that put force on my upper body (pushed heavy doors with the arm on the unaffected side for instance).

    My twin is having a prophylactic double mastectomy as we are BRCA2 girls.  She is having a DIEP but hasn't had it yet having just had her ovaries out (also prophylactic) so sorry I can't give any advice on the DIEP front at all.

    The healthier you are and the more you look after your skin now the easier it is going to be for you so don't stop good skin care just because radiotherapy is over, keep it up at least until after your surgery.  And if you are likely to have more treatment in the future then it's a good idea just to keep good skin care up altogether even if you dial it back to moisturising once a day or once every two days.

    Hope that has helped a little.  I am majorly impressed with my implant reconstruction and genuinely had no issues, didn't even take any painkillers after the ones from the surgery had worn off.  Although I have a very high pain threshold and morphine derivatives or anything like ibuprofen make me sick, so if they work for you then take them :)

    Best wishes for the surgery,

    LJx

  • I had a DiEP last Wednesday (a week today). I came home yesterday. A little sore around tummy scar but I am taking paracetamol only. Breast looks good and swelling is going down. 

    I am yet to have radiotherapy but will have it once healed.