I can share my story.  After my first diagnosis, stage 1, I had a bilateral mastectomy with silicone plant reconstruction.  Because my tumor was smaller and all the sentinel nodes were negative, radiation wasn't recommended.  About a year after my implant surgery, we found a recurrence to the internal mammary nodes under the sternum.  They couldn't be surgically removed so I had more chemo and then full radiation to the breast area, axilla and all regional nodes.  The treatment put me into remission which was the best possible news.  The radiation did however, alter the right implant and skin area.  Before both implants were very symmetrical.  The right one is smaller, harder and shifted higher on my chest.  I've come to peace with the results as my only goal was to do whatever necessary to fight this disease.  I'm also older now so the cosmetic aspect doesn't bother me.  I know that any attempt to reconstruct again will be risky due to the radiation damage so until they need to be removed, I'll just live with the results.  I hope this helps.

Donna