Breast Reconstruction After Lumpectomy and Radiation?

Is it possible to have Breast reconstruction after a lumpectomy and radiation?

Doctor Answers (17)

Breast reconstruction after lumpectomy and radiation.

+5

Just to add to what has already been said.  My algorithm for tackling a lumpectomy defect is to ask if you are happy with the volume of breast that you are left with or not.

If you are happy with the volume of breast that you have left, you may need to have the breast reshaped which can often be done in the form of an uplift.  You may need a balancing uplift/reduction on the other side.

If you are not happy with the volume, then you need to have volume added.  This can either be in the form of fat transfer or a latissimus dorsi flap.


Birmingham Plastic Surgeon
5.0 out of 5 stars 9 reviews

Yes breast reconstruction is possible after lumpectomy & radiation

+2

Yes, it is possible to have breast reconstruction after lumpectomy and radiation. However, it tends to have a higher rate of complications due to the compromised blood supply and wound healing. This is especially true when reconstruction is acheived with implants. It is more likely that you will benefit from the use of vascualrized tissue in breast reconstruction.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 48 reviews

Absolutely Possible. See the Plastic Surgeon before the tumor surgery.

+2

There are many things that can be done to reconstruct a breast after lumpectomy and radiation. Options include use of a small implant, use of a small local flap, a mastopexy (uplift) type operation to reshape the breast and standard, more invasive types of procedures. No matter what is done, the best plan is to see a Plastic Surgeon before the initial procedure. He/she can work with the general surgeon and plan the procedure so that a minimal defect will be left. In people with a reasonable sized breast, this may involve using a reduction incision and removing the tumor as one would remove the tissue in a breast reduction, thus resulting in a normal appearing breast that was easier to obtain than after an initial procedure with an incision in an inconvenient location.

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 4 reviews

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BREAST RECONSTRUCTION AFTER LUMPECTOMY AND RADIATION

+1
Typically breast reconstruction can be done on a patient who has undergone a lumpectomy and then radiation.  However, the type of reconstruction that can be done may be limited depending on the condition of your skin after radiation.  Irradiated skin has more difficulty holding an implant than non-irradiated skin which can increase the risk of capsular contracture after implant reconstruction.  Autologous reconstruction is the alternative to implant reconstruction but not everyone is a candidate for autologous reconstruction for various reasons such as poor health or the patient’s body habitus.  I recommend researching for board certified plastic surgeons that have experience working with breast cancer survivors.  Then schedule a consultation for a thorough examination.  After reviewing your medical history and performing a physical exam, your surgeon will be able to tell you the best reconstruction option for you.

Congratulations on being a survivor!Be well and good luck!

@norrisplastic

Morgan E. Norris, MD, FACS
Houston Plastic Surgeon
4.5 out of 5 stars 18 reviews

Breast reconstruction after lumpectomy and raiation?

+1
Hello!  Thank you for your question.  Yes - you are certainly a candidate to have reconstruction of your deformity from your cancer surgery.  Fat grafting has become a popular procedure to improve aesthetic outcome following breast reconstruction or for improvement of contour after lumpectomy. Much of the newest research has investigated the properties of fat, in terms of its stem cell properties and associated advantages. It has significantly ameliorated radiation damage by increasing vascularity. Also, it adds additional "fatty tissue" atop the reconstructed breast mound to further contour any concavities or deformities, while also masking implant visibility with rippling and such.

At our Breast Reconstruction Center, we have utilizing this technique almost routinely to maximize the aesthetic outcomes after lumpectomy or mastectomy. We have utilized the micro-fat grafting technique, and have been obtaining maximal fat graft survival into the breast. After harvesting of the fat from areas with excess fat, usually the belly, hips, or thighs, the fat is processed and injected back into the breast using the aforementioned techniques. Our patients have been very happy with the results as well as the areas where the liposuction was performed. Contour has been much improved using the micro-fat grafting technique, and the downtime is minimal.

Fat grafting has become a mainstay in breast reconstruction and has added another edge to breast reconstruction for aesthetics with minimal morbidity and complications.

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 12 reviews

Reconstruction after lumpectomy

+1
The deformity of a breast after lumpectomy and radiation ranges from very mild to severe. This can cause asymmetries that are difficult to reconstruct. It is possible to repair the deformities left by radiation with multiple techniques--implants, breast lift or reduction, and addition of tissues from another part of the body often the back (latissimus). Even more often, a procedure is required for the normal side in order to lift or reduce that breast to make the two symmetric in volume. These procedures are most often covered by insurance. It is more common, however, to have complications on the radiated side after surgery and this should be discussed with your plastic surgeon. Be sure to speak with a board-certified plastic surgeon and ask questions about the both the cancer and the noncancer breast.

Kendall Roehl, MD
Houston Plastic Surgeon
5.0 out of 5 stars 3 reviews

Yes you can have a breast reconstruction after lumpectomy!

+1
Please have a consult.  There are multiple options for patients who are have an issue after there lumpectomy and radiation therapy.The most like case scenario is performing fat grafting to this area. This involves using liposuction to obtain fat from one area of the body like the love hand and move it to another area.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!

Fat grafting is a valuable tool in breast surgery. This technique has gained more popularity over the past 7 years. There are many techniques used to harvest the fat, process the fat and then re-inject the fat. Conventional suction lipectomy is performed with a small diameter cannula, processed by separating the liquid and fibrous tissue from the fat, and then placed into syringes for re-injection or through a closed system.

Robert Whitfield, MD, FACS
Austin Plastic Surgeon
5.0 out of 5 stars 14 reviews

Lumpectomy and radiation

+1

Implants should never be used alone in a radiated breast unless it is combined with another flap for coverage. To get more volume in a radiated field you need to use your own tissue. A TRAM flap is just one tool used in breast reconstruction. It sacrifices your stomach muscle but provides fat on a leash to your breast.. Another is a DIEP flap which also uses your belly tissue but does not sacrifice your stomach muscles. It essentially uses the same tissue that would be discarded in a tummy tuck but relocates the tissue to create a breast. A third option is the Latisimus flap (back muscle); its best use is along with an implant. These "autologous" tissue (your own tissue) can be used in any breast reconstruction. Women prefer it because it is their own tissue. It is also an excellent option for someone who has had radiation. You should consult with a plastic surgeon who offers all three of these methods as well as the implants, so that you have the best choice of options

Raj S. Ambay, MD
Tampa Plastic Surgeon
4.0 out of 5 stars 16 reviews

Breast Reconstruction After Lumpectomy and Radiation

+1

Absolutely! Sometimes at the time of lumpectomy, a plastic surgeon can be there with the breast surgeon to reshape the breast immediately. You may want to coordinate your care with both surgeons if you haven’t had your lumpectomy yet. Even if that wasn’t the case, reconstruction to a breast treated with lumpectomy and radiation is possible later on. Radiation often changes the skin, or the breast is just smaller after lumpectomy. Fat grafting from elsewhere in your body can be a wonderful way to enhance the size of the breast and to reverse the skin changes. In other cases, a small implant may be helpful. Every lumpectomy and radiation situation is unique, but most problems can be improved with reconstruction. Good luck.

James N. Romanelli, MD, FACS
Long Island Plastic Surgeon
5.0 out of 5 stars 13 reviews

Breast reconstruction is possible after lumpectomy and radiotherapy

+1

Increasingly, the goal of breast surgeons is to preserve as much breast tissue as possible by only removing the cancer (lumpectomy) and the treating the remaining breast tissue with radiotherapy. This has been shown to have the same cancer control rate as having a mastectomy.

Sometimes the cosmetic results from this "breast conservation" surgery are excellent - but sometimes they are not. Lumpectomy reconstruction after radiotherapy in my practice generally involves replacing the portion of the breast which has been removed with a "flap" of tissue from the back (a latissimus dorsi flap). If a large amount of skin has been removed and the position of the nipple has been affected by the lumpectomy, skin from the back will the taken from the back as part of the flap and used to replace the skin that was removed in the cancer treatment.

Some patients, in addition to reconstructing the lumpectomy defect, also want their breasts to be larger. The latissimus dorsi flap can be used to cover a breast implant of tissue expander, while the unoperated breast undergoes a standard breast augmentation.

A newer technique is to reconstruct the lumpectomy defect is with fat grafting (performing liposuction elsewhere, separating out and then re-injectig the fat into your breast fill the hole) - but I don't think the jury is in on the safety of this technique in patients who have previously had breast cancer (although I know some of my colleagues will disagree!)

I hope this helps.

Damian Marucci, MBBS, FRACS
Australia Plastic Surgeon
5.0 out of 5 stars 4 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.