Breast Implants After Lumpectomy and Radiation?

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.

Doctor Answers 35

Breast implant after lumpectomy and radiation

Radiation significantly increases complication rates on breast implant i.e. capsular contracture, wound healing problem, and implant extrusion. Furthermore, lumpectomy often leaves behind contour regularity i.e. devits  that would not be corrected with placement of an implant alone. After a lumpectomy and radiation, plastic surgeons often elect to use vascularized tissue to restore your breast shape and volume.  I highly recommend that you get a formal consultation with a breast reconstructive plastic surgeon for a full evaluation.

Los Angeles Plastic Surgeon
5.0 out of 5 stars 4 reviews


Radiation is not the same in everyone. If the tissues are soft and skin pliable after lumpectomy and radiation,implants can be used. Yes, there is an increased risk of capsule formation,but many patients do well. Talk to a plastic surgeon  with experience in lumpectomy reconstruction options.

William C. Rigano, MD
Dayton Plastic Surgeon
5.0 out of 5 stars 8 reviews

Implants after Lumpectomy and Radiation

The effects of radiation are different for every woman, and unfortunately, it is often not possible to know how radiation will impact your healing process after surgery on that breast. In general, using implants in a radiated breast is something I do not usually recommend. There can be up to a 40% risk of complications (infection, wound healing issues, capsular contracture) and ultimate "reconstructive failure" from an implant-based approach. There are often other options including rearranging the breast or adding healthy tissue to that radiated breast that are better options from a risk/benefit standpoint.  In addition, procedures for the opposite breast are available to improve breast symmetry. Your plastic surgeon should be able to help guide you in this decision-making process.

Implants after lumpectomy and radiation

You really need to be seen in consultation with a plastic surgeon that does a lot of breast reconstruction.  There are many ways to reconstruct breasts and each technique has its place.  Generally radiation makes implants slightly higher risk for a variety of complications. But more importantly, implants ofter are not the first treatment choice after a lumpectomy.  I strongly suggest seeking the opinion of a surgeon that can examine you and discuss your care thoroughly.

Rodger Shortt, FRCSC
Toronto Plastic Surgeon
5.0 out of 5 stars 27 reviews

Breast implants and radiation can be a difficult combination!

I am very selective in the use of implants after radiation therapy.  The tissues are no longer the same.Please find an experienced Board Certified Plastic Surgeon and member of the Aesthetic Society using the Smart Beauty Guide. These Plastic Surgeons can guide you on all aspects of facial surgery, breast augmentation and body procedures including tummy tucks or mommy makeovers!

Three basic forms of breast reconstruction exist. You can use your own tissue, implants or a combination of the previous two techniques. Your own tissue can be used in the form of the DIEP flap, PAP flap, SGAP flap or fat grafting. Implants can be done in one stage or two stage. Two stage reconstructions are started by placing expanders at the time of mastectomy. Once they expanders are placed they are able to be inflated as determined by wound healing. The final time consists of combining any of the above techniques.

If you are interested in being seen in Austin please give us a call. I know this is a difficult time for you. Please choose your surgeon carefully. Read their reviews to evaluate how their patients feel about their experience.  The majority of my practice is devoted to reconstruction for women with breast cancer or who are BRCA+

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. 

Dr. Gill

Paul S. Gill, MD
Houston Plastic Surgeon
5.0 out of 5 stars 65 reviews

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.

Breast Implants After Lumpectomy and Radiation

In general, breast implants do not work well in radiated fields.  You may be able to get an implant in but it is doubtful that it will be as natural as the non-irradiated side.  There are studies by some surgeons claiming good success in selected patients, but my sense is that their definition of success and mine are very different.

Implants following lumpectomy and radiation

Contour deformities or asymmetry between size/shape of the other breast following lumpectomy and radiation may occur after everything settles.  There are several options to ameliorate this and you should discuss your options with your plastic surgeon to determine which option would be best for you.  It is recommended to wait approximately one year after your radiation therapy is completed before considering any reconstructive procedure on the breast.


Typically, implants in the setting of an irradiated breast has higher rates of complication, including infection, wound complications, capsular contracture, etc.  Many surgeons, including myself, have placed implants to improve symmetry in these instances with excellent results.  However, if your deformity is a contour issue with a soft tissue deficiency, placing an implant beneath the breast may actually worsen the deformity as it is not addressing the issue to "fill" the defect.  For such problems, it may be a wiser decision to consider fat grafting for smaller defects, where fat is harvested for another area of your body and then reinjected into the defect, thus adding volume as well as having the added properties of fat graft stem cells.  Autologous flaps such as local tissue, TAP, or LDMF may be needed for larger soft tissue defects.  

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 14 reviews

Breast reconstruction after lumpectomy

Breast reconstruction either with implants or autogenous tissue can be performed after lumpectomy and radiation.  Most lumpectomy procedures do not require any reconstruction though.  Please visit with a board certified plastic surgeon for a detailed exam and evaluation.

David Finkle, MD
Omaha Plastic Surgeon
5.0 out of 5 stars 62 reviews

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.