Has anyone had breast reconstruction revisions after initial surgery?

[Bangersndmash]

Hi, has anyone had breast reconstruction revisions… for instance, I had a double mastectomy with DEIP flap reconstruction. After 3-4 weeks I accepted my new body and was relatively happy with the results, it looked natural.

Then I had radiation and it’s really really shrank one side, (which was smaller anyway), and on the other side I’ve had fat necrosis and it’s gone a bit of a wonky shape.

i am due to speak to my surgeon soon but wanted to know if anyone else had had surgery, and then revisions to fix things they weren’t happy with. I am considering implants.

has anyone had any revisions after the first surgery? What did you have, how did you find it, are you happy now?

I think you have a right to revisions because they should not have done the reconstruction surgery until after the radiation. I’m kind of shocked they did that imho. DIEP flap can be done months or even years after the mastectomy. Madness to have done it before radiation and it probably delayed the radiation a bit too.

i don’t think it’s madness, It is dependent upon what cancer type of cancer and what stage you have, but most radiotherapy is given post surgery. It is very common.

it did not delay my radiation, please don’t say such things when you really don’t know the full picture and you aren’t a medical professional. I don’t know if you’re trying to be helpful but I find your comments really hurtful and rude.

Sorry, I don’t mean to be hurtful or rude.

Just the hospital where I had my breast cancer treated it was the surgery to remove the cancer (mastectomy ) then radiation and then reconstructive surgery because of exactly what you have experienced.

I was shocked they did the reconstructive surgery before radiation.

I think you should have revisions at no cost to yourself.

I am not a medical professional, I am speaking from my experience as a breast cancer patient and attending support groups with other breast cancer patients as well as my sister and aunts experiences as breast cancer patients.

Yes, I had two revisions and then nipple reconstruction after my DIEP surgery. I had a single mastectomy and my surgeon told me that he always made thr new breast a bit bigger because it was easier to go back later and reduce the size slightly to even it up with the existing breast. The first time I had the little dog ears removed from the sides of my stomach scar, and liposuction to my reconstructed boob, and the second time, one of the dog ears was tweaked a bit more and I had more lipo to my hips and new boob. I had to wait for six months for the first surgery until everything had settled down from the main operation. The second revision was a couple of months later and then the nipple reconstruction was about another month after that, followed by tattoing. It was 12 years ago now but I can still remember bursting into tears when I took the bandage off a few days after the tattooing and saw my new nipple - the surgeons did such a wonderful job with everything and seeing my new nipple gave me a real sense that the worst was over. I never could have believed what the surgeons were able to do and am so thankful that I was offered a DIEP reconstruction. Ive got no regrets at all about having the revisions

@Bangersndmash Yes I did! I had a single mastectomy with immediate reconstruction which went well. But the results came back with needing chemo which wasn't in the treatment plan and then radiotherapy. Like yours, that did the damage and I ended up with a hard necrosis which had two attempts at draining and softening. In the end my surgeon suggested a TDAP operation which took a chunk from my back - was tunnelled under the skin and armpit and after removing the necrosis was laid on top of the original DIEP. So I now have two pedicles within the reconstruction each with their own blood supply. Tattooing was done once everything was healed and ready. Fabulous job!! and i was really happy with the results as was my consulting surgeon.

Revisions ARE done at no cost for patients who have had flap reconstruction.

Delayed reconstruction is not always the best option if radiotherapy is needed. There are disadvantages to the delayed approach and for some women immediate reconstruction prior to radiotherapy is the best or only option. Just because your surgeon/hospital feels delayed reconstruction is best, doesn’t mean that applies to OPs team or case. The choice of surgery is a complex decision and people will choose different options according to their own individual circumstances and priorities.

Those who have had issues after radiotherapy, can I ask if this was chest wall or axillary radiotherapy please?

I think the timing of reconstruction also depends on the individual’s preferences as well as other treatment. For me, being told I needed a mastectomy was more horrific than knowing I had cancer and I just couldn’t begin to contemplate waking up without a breast, but I realise that many women dont feel the same way. At the time of my surgery, it wasnt clear whether I would need chemo or radiotherapy, but the surgeon was happy to do an immediate reconstruction anyway. As it turned out, I was very fortunate that I didn’t need either and just had five years of hormone therapy.