Breast Implants After Lumpectomy and Radiation?
- Asked by healer in NC
- 4 years ago
Do you recommend breast implants after a lumpectomy and radiation? If so, what type of implants and what are the pros and cons of this type of surgery? I had the lumpectomy/radiation a year ago. My breast tissue is soft and most of the discoloration is gone. Are there studies I can read? Thank you.
Generally speaking, there is a higher chance of problems using breast implants in a patient who has had previous radiation to th
compared with a woman who has never had radiation therapy. Having said that, I would not eliminate expanders and implants as an option before having a consultation with a plastic surgeon experienced in both implant and autologous (or self) tissue reconstruction of the breasts. It may be that in your particular case the expander implant approach is still a good option despite the higher complication rate. And when we speak of complications related to radiation, we're typically talking about a failed reconstruction requiring another approach rather than any life or limb threatening complication. There are so many factors involved in this decision that it really is best tailored to your individual situation, and you would be best served by consulting with two or three different surgeons in your area....
Web reference: http://www.plasticsurgeryweb.com
Breast implant reconstruction after radiation
The truth is that breast implants are used after radiation in patients and many patients do well. What we see as experts in breast reconstruction is a bias towards those patients who have failed breast implants in the setting of radiation, requiring redo reconstruction. It is radiation dose dependent and no one can make summary opinions on this matter.
Web reference: http://www.karemd.com
Breast Implants after Radiation & Lumpectomy
Breast Implants can be placed after radiation and lumpectomy treatment for breast cancer. However, the rate of complications is significantly higher. You should consult with a board certified plastic surgeons who can evaluate your particular needs and goals. Often there maybe other options including soft-tissue rearrangement or autologous flaps.
Recent Breast Reconstruction Reviews
Breast Reconstruction Photos
Implants and Breast Radiation
Wow...Healer, you have recieved some fantastic advice here, isn't www.realself.com a great outlet and resource for you! (FYI, I do not work for them, but think this is a great site).
I generally do not recommend breats implant after breast irradiation. The plastic surgery literature documents a higher rate of complications and I have seen a number of patients in my office from other surgeons who have received implants in the irradiated breast. However, not all 2 patients are alike and every patient comes with individual needs, wants, goals and expectations. We as scientific, evidence based surgeons use the peer-reviewed literature as practice guides for standardizing care. I would recommend you see a Board Certified Plastic and Reconstructive surgeon (www.plasticsurgery.org) who can evaluate your individual case and make appropriate recommendations!
The reconstructive options after Lumpectomy and radiation are good. The post effects of radiation is different on everyone. There are options like tissue expansion first if the breast is tight and shrunken, followed by a permanent implant. Good luck!
Breast implants generally not recommended for irradiated breasts
Generally, implants are not recommended in an irradiated breast. The rate of complications and contracture is much higher. It does not mean that it can never be done, but you must be informed of the risks and alternatives.
In some cases, there may be better options, such as a local tissue rearrangement or the use of autogenous tissue.
Best to discuss all of these with your plastic surgeon.
Breast implants and radiation
In general, breast implants and radiation don't mix. The risk of capsular contracture in this setting is so high as to be almost a certainty.
Web reference: http://www.randcosmeticsurgery.com
Breast reconstruction with implants following breast cancer reconstruction
Here is a layman and succint explanation of the issues:
However, in summary, there are an increased risk of complications. Generally most surgeons prefer to use your own vascularized tissues .
Implants after lumpectomy with radiation
Generally speaking, we try to avoid operating on radiated breast tissue because of the higher risk of wound healing problems, infection, and scar tissue formation. This is secondary to the decreased blood flow through this tissue.
For this reason, we try to avoid performing breast lifts, breast reductions, or breast augmentations after radiation. This is an area of breast surgery that needs more research. I frequently see women with previous breast augmentations, undergo lumpectomy and radiation to subsequently develop capsular contracture. At this point, it is a very difficult problem to fix. However, if they had undergone a nipple sparing mastectomy and implant reconstruction, the radiation could have been avoided in most cases.
Bottomline, radiation is a risk factor for any type of plastic surgery, especially breast augmentation afterwards. I would caution against this as the risks may easily outweigh the reward.
Web reference: http://www.drpaulgill.com
Increased complication rate for breast augmentation following radiotherapy
Radiotherapy permanently and progressively impairs the healing ability of tissues in the body. For patients wanting an augmentation after lumpectomy/radiotherapy, I recommend putting the implant in a submuscular plane AND transferring the latissimus dorsi muscle (large back muscle) from the back to the chest to cover the lower pole of the implant. This way, the implant is wrapped in muscle with a good blood supply and this will hopefully decrease the incidence of complications such as infection, extrusion, wound healing probelms and capsular contracture.
There was a recent study published in the journal PRS which looked at the use of acellular dermal matrix to cover the tissue expander/implant in patients who had previously had chest wall radiotherapy and were now undergoing mastectomy/immediate recon. This study found an acceptable complication rate without the increased surgery and scarring of a latissimus dorsi flap.
I hope this helps.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.