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Radiated skin and future cosmetic surgery.

Eil4186's picture
Eil4186
Posts: 967
Joined: Dec 2007

Hi, I had lumpectomy, chemo and radiation in 06. Recently I have felt that I would like to have a breast lift. At my consultation, the surgeon said that radiated skin has a compromised blood supply and it relies on the skin around it. He said that because of this, there is a risk that the skin will die as a result of the surgery. He also said that my port incision could cause complications on the other side. I am very disappointed. He did say though that radiated skin sometimes recovers somewhat after 10 yrs or so and that a lift might be possible at that time. That's forever away!! I'm just wondering if any of you have heard this before. Thanks.

StarWish624
Posts: 7
Joined: Feb 2008

I am surprised at how much actual information you were given. I have heard so many others say that Doctor's don't want to really explain why they try to dissuade us from reconstruction after radiation treatments. I got such a wishy-washy "response" from a Doctor, that I had to get a second opinion (and almost an argument) to get a straight answer. AND they tried to make me feel stupid for asking for the second opinion in the first place (like I was wasting the Doctor's time with such foolish questions).
If it is sooooooo complicated to do reconstruction after-the-fact (rads.), then WHY don't they just do ALL reconstructions BEFORE (when the skin is OK)?
P. S. I am awaiting my reconstruction, too, from 2007. You are NOT alone.

meena1's picture
meena1
Posts: 1005
Joined: Oct 2008

I have also been told the same thing. I had an expander put in when i had my masectomy last year. From what i have been told, radiated skin does not hold the implant in very well. There are 2 sugeries that are used for radiated skin. One is the Tram flap where they take skin from you stomach and the other is a diem flap where they take muscle from your back to hold the implant. They are both Major surgerys with a long recovery period. Radiation damages the skin and tissue so reconstruction is tricky. I live in Philadelphia Pa, and i know a very good plastic surgeon.

cats_toy's picture
cats_toy
Posts: 1463
Joined: Feb 2009

Yes I had a partial mastectomy, chemo and radiation. When I finally decided to get reconstruction, the plastic surgeons all recommended cutting away the radiated skin because of bad blood supply. I had the "free flap" surgery, where they actually remove the skin from the tummy and attach it the breast to help form a "natural" looking breast, then had an implant in the other to try making them both look fairly the same. The radiated skin that was left behind had issues with healing, but eventually closed up. I know this is a completely personal decision, and even though I have had issues throughout, I am not sorry I had it done.
Hope this helps a bit, and if I can answer any other questions, let me know!
Cat

Eil4186's picture
Eil4186
Posts: 967
Joined: Dec 2007

Hi Cat, so the radiated skin did not die, just took longer to heal? What did they do to help the situation?

cats_toy's picture
cats_toy
Posts: 1463
Joined: Feb 2009

I actually went to three different plastic surgeons before deciding what to do. They all had different ideas, one even told me that I should just get a mastectomy so I wont have to worry about mammograms again...go figure.
The skin did not heal on its own, I went in again and they did a revision, that time it did stay closed. There are always issues with surgery, but it sounds as if you really want this done, so I would get even more information from other docs before giving up.
Stay positive
Cat

Eil4186's picture
Eil4186
Posts: 967
Joined: Dec 2007

At first I didn't understand, because the incision would be below the nipple and my lumpectomy is well above the nipple. But the surgeon said that he would have to separate the skin from the breast tissue in order to reposition the breast in a higher position. This separation would prevent the radiated skin from relying on nearby skin for blood as it has been doing since the radiation. This is all new to me. So now I cannot have my boob lift. Just another way that cancer has screwed me over. Pardon my bluntness. I'm just very disappointed is all. My breasts are uneven, and scarred, I just thought that with a lift I could make them look a bit better. Thanks for your responses girls.

DebbyM's picture
DebbyM
Posts: 3294
Joined: Oct 2009

So sorry Eil. Maybe there is still something you could do sooner. Wishing you luck!

Has anyone heard of the plastic surgeon's injecting something in your breast to make it fuller? Like collagen or stomach fat or something? I thought I read that on here.

Eil4186's picture
Eil4186
Posts: 967
Joined: Dec 2007

Thanks girls for your advise. I contacted a second surgeon and he concurred with the first. He said he wouln't even consider operating on irradiated skin. I guess that is that.

carkris's picture
carkris
Posts: 4547
Joined: Aug 2009

I wonder if it depends on where you live?

jnl's picture
jnl
Posts: 3873
Joined: May 2009

I am really surprised that a PS won't operate on someone who had radiation. I guess I am ignorant inre to that. I assumed they could. I thought it might depend on what that individual's skin was like, since we all react differently to rads. Is that why so many have the expander's put in before rads?

Kylez's picture
Kylez
Posts: 3765
Joined: May 2009

I am sorry Eil that you can't have the surgery that you want. I didn't realize they wouldn't or couldn't operate on radiated skin.

Cancer Radiated Guy
Posts: 1
Joined: May 2010

I came across this discussion by way of Google. I am a 55 yr old male and I was again searching for a Doctor that specializes in operating on radiated skin. I know it is a waste of time but still trying . I had a good portion of my nose removed due to cancer and had it reconstructed and it looked pretty good. Then the cancer spread to my neck. I had that removed by surgery and since the cancer moved I had to undergo chemo and radiation. The radiation totally destroyed my nose by shrinking the skin tissue. Looked like a boxer of 50 years. I then had a forehead flap to fix it (where they take a 2" strip of skin from the forehead). This was non radiated skin but would not take due to trying to attach it to radiated skin. I have tried over 18 procedures now and I can tell you and sorry to say that after radiation your chaces of plastic surgery reconstruction are nil to VERY slim if not impossible. In short I guess we have to thank God we are still alive. Held my two grankids yesterday !!!! Screw cancer.

Mama G
Posts: 764
Joined: Nov 2009

I have a very close friend who chose to have implants before her radiation, then went back in to have a lift. She has now had 4 more surgeries and each one gets worse and worse as they try to repair the damage done with the prior surgery. I say just be glad you have boobs! From what I've heard my friend go through I wouldn't want anyone to have that pain and heartbreak. She is now battling a severe infection that resulted from the last surgery. It's going on 3 weeks of bed-rest. Not fun.

Mama G
Posts: 764
Joined: Nov 2009

double post

deeb111
Posts: 139
Joined: May 2011

 Im told that it is still possible for me to get mastectomy and reconstruc if i so choose cause i have tremendous amounts of pain in cancer side and had abcess on chest wall very bad cellulitis 2 years out was in hospital for 5 days so im almost at the point of wanting them removed just cant deal anymore so ive heard it is possible maybe pending what kind of reconstruc u do my original surgery for was partial mastectomy on left with bilateral reduction and grafts  so that was april 6 2011

 

 

 

 

 

 

chirop777's picture
chirop777
Posts: 1
Joined: Mar 2015

I would look into hyperbaric treatment. This helps with increasing blood suppy and oxygen to radiated tissue and may improve the condition of your breast tissue for a future breast surgery. I looked into this because I would like reconstructive surgery due to breast cancer and I did research and found out that hyperbaric treatments help improve radiated skin. I unfortunately have terrible scar tissue and learned that this helps to improve the radiated skin. I hope this helps :) Mich

 

Lilly9
Posts: 152
Joined: Oct 2014

I had a bi-lateral in July 2013.  Had expanders placed at the time.  Filled and on to 34 rounds of radiation.  I had permanent implants placed in July 2014.   In June I will be having additional surgery.   The radiated side - the skin tightened around the implant.   In June my PS will "re-do" my left side to bring back the symmetry by reducing it and evening me out.   His only hesitation about operating on my right side was that it's not been a year yet and because radiated tissue is tighter there's just no guarantee it wouldn't do it again.   When I suggested the alternative of the left side - it was literally like a light went on!  He said - as a surgeon you get so use to wanting to fix what is obviuosly wrong - sometimes not thinking outside the box.  My PS is one of the only in our area that will place expanders knowing you're going to have extensive radiation.  Don't give up - and never say never.  They're making tremendous strides in all areas, including plastic surgery

GlowMore's picture
GlowMore
Posts: 638
Joined: Feb 2008

In reading these posts just noticed that the original post was made in 2010 and that gal has not been back since 2012....but the post is still relavent to all who have this problem.    However...the thing I thought of first of all when reading all of the above was how the morning after my Lumpectomy I was so devasted by the way I looked and how my left breast was pointing off in a different direction and how uneven I was and I felt like a Freak....(and had not even HAD my Radiation yet).......but anyway....  I remember I called my Friend Julie who had gone thru so much the year before ...she had a Mastectomy and tried to have reconstruction at the same time but did not heal and had a terrible time of it and finally just stopped the process....so anyway.... I was so full of ME that I forgot about HER...and I called her and I was crying and crying....and I said:  "Oh Julie....I'm pointing in the wrong direction" .        And Julie said to me:

"Gloria...  I'm not pointing at all".

                *** We must remember that we are in a battle for our lives and no matter how badly we think we look....we need to remember others look as badly or worse and that the main thing is SURVIVAL.....and for some unknown reason God has allowed me to Survive for over 12 years since the end of chemo and radiation.   Prayers for all of you for Strength and Courage.   Hugs sent to all also.     Glo

mdqxx
Posts: 6
Joined: May 2015

Thank you! I was humbled and reminded of this after speaking with a fellow cancer patient undergoing radiation ...we have same schedule.  I have been vy concerned about the cosmetics and found her options even worse.  Bless you all...

wickedwoman's picture
wickedwoman
Posts: 1
Joined: Apr 2015

Hello! I'm new to this site, so if I do something wrong, please forgive me and politely let me know. I had my cancer in 2005 and this December will mark 10 years clean, I hope. I had a very small medullary carcinoma of the breast and adenocarcinoma of the lymph nodes under my arm, above my collar bone and along my sternum that was only identified as being neither a breast or lymph node originated cancer. I had chemo, a lumpectomy with lymph nodes removed under my arm and then radiation. The following January I was tested for the BRCA genes and was positive for BRCA2. Why this test was not offered to me at the start, Idk, considering my extensive family history and I was only 32 years old at the time. I opted for a BMX with reconstruction, which took the entire next year to complete. I was told that the doc I had was the best for this type of reconstruction in the city. My results are disastrous! Maybe I expected too much, but I was assured it would be no problem and other than the nipples having a sketchy outcome, it would look as good as before. Unfortunately, not remotely true! Don't get me wrong, I am thankful to be alive, but had I known it would look like this, I would have opted for prosthesis. I am so ashamed of the outcome, I have resigned myself to the fact of being alone for the rest of my life. They are not the same size, shape or nipple color or placement as each other. My advice to anyone considering reconstruction after rads is to ask for before and after photos, do your homework and think about it really hard before you make your decision. Also, I had muscle from a cadaver used in my surgery to help support the implants. Idk if they still do that or not. Sorry so long.

mdqxx
Posts: 6
Joined: May 2015

Thank you for sharing your journey...I'm so sorry it didn't work out! This is happening to thousands of women and we all need better information in able to make the best choices.  Love to you!

mdqxx
Posts: 6
Joined: May 2015

I too saw surgeon and he reccommended lift prior to radiation...I believe this is one reason patients are choosing mastectomy over lumpectomy trend and drs are alarmed.  I did not do this...but still wonder what's in the future.  My mother who had lumpectomy & radiation in the 80's did have success breast lift 5 yrs ago & is vy happy...but that has been a long time as well.  Let us know...

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