Is silicone safe for breast reconstruction?

[Cristy1019]

For a double mastectomy, which implant would be the safest?  Silicone, saline, or biological?  How proven are the implants made from fatty tissue in abdomen?  Thanks.

[SueYoung55]

The reasons that plastic surgeons don't recommend implants and or expanders for radiated skin is:

1) 70 to 90% failure rate

Why would it fail?
Radiated skin doesn't stretch.
Radiation also gets the rib cage and weakens it.
Capsular contraction is likely.
Radiation effects everything in it's path. Heart, lungs, rib cage, cancer......

If you put an expander in on both breasts, and started the expansion process, it's possible the rib cage on the radiated side would push inward with the expansion where as the other breast without radiation would push outward as planned. This because of a weakened rib cage. Also, the skin doesn't stretch and there have been many cases of the skin tearing as it's so thin after radiation.

I didn't say they don't do them. I said they don't recommend them and for the reasons above. I had my reconstruction done a few months ago after waiting a year and a half after my first mastectomy. There is a small percentage of women who have done well after this surgery. I wouldn't ever choose those odds for myself.

Ps.. my plastic surgeon does corrective surgeries on reconstructions gone bad, sadly he does this all the time. Research, research, research!!! And don't be afraid to ask questions. Get second & third opinions. Don't take our word for it, find out for yourself.

Best wishes

[Lisa1002b]

Implants are done all of the time after radiation. The type and kind depend upon the procedure for reconstruction. There are many more options now - just in the past couple of years. At any rate, implants ARE used regularly after radiation. The key is that you have a reconstruction surgeon who specializes in reconstruction after radiation. Sue is correct that that the diep is not an implant, it is fatty tissue (if you have enough of it and in the right place) that still has muscle attached. I have seen the outcomes with these procedures in friends and have been impressed.

I was not a candidate for the diep procedure because I am small, petite and they simply could not create two breasts (I had a bilateral mastectomy) from my stomach or anywhere else.

Anyway, I am new here and not trying to come off like a "know it all". I simply do know that implants are used all of the time, successfully, with good outcomes, after radiation. The key is to have a surgeon who knows how to do it. It requires the use of expanders, of course. And, it requires what would likely (in the past) be considered an over-expansion of the breast that is to be radiated. Then, it is about a year wait - AFTER - radiation is complete before you put in the implant.

As far as silicone vs saline, well, saline will can show wrinkles through the skin - if you have had a skin sparing type of mastectomy. Whereas a silicone implant will not. But, again, you need a surgeon to give you these answers. And, if you are having radiation, you absolutely CAN have an implant after radiation. But, you need to have it done by someone who specializes in breast reconstruction after radiation.

This is a new field really, emerging - now that the law requires insurance companies to pay for reconstruction - it has created a medical niche.

I don't know where you are located geographically, but there are many specialists in CA that work just with this very situation.

You have options.

Good luck and God bless!

[SueYoung55]

Cristy... the fatty tissue in the abdomen is NOT an implant like you think. LOL

With DIEP they re-attach the blood supply so the flap lives.

If you've had radiation I would NOT recommend any implant. I don't even know a plastic surgeon who would recommend that.