Breast Reconstruction After Lumpectomy and Radiation?

Isolated defects of the breast secondary to a lumpectomy are nicely improved with fat transfer. This is a procedure I perform in the office comfortably under local anesthesia. See the attached video for a demonstration.  

The short answer is yes: there are lots of options.  In general, rearranging what you have left after radiotherapy and a lumpectomy can give good results, but is relatively high risk for wound healing problems that could leave you worse off than you are already.  Radiotherapy has lots of benefits for cancer treatment and reducing the risk of recurrence.  It also, however, compromises the ability of the breast to heal with further surgery.  The best options therefore tend to depend on whether there is a contour irregularity (like a dent) or a shape problem that you would like corrected or whether the issue is simply a size discrepancy between the two breasts.  If the issue is purely size the simplest options would be to either make the radiotherapy side larger with fat injections or the normal side smaller with a slight breast reduction.  If the issue is a small contour irregularity or some sort of indent at the site of the previous lumpectomy, with or without a small size discrepancy, fat injections may still be a good option.  They often require one or two top up procedures though.  More significant shape or contour issues often require tissue to be brought in from elsewhere.  This can either be done using small tissue volumes from the chest near the breast or from somewhere else further away on the body (like the lower abdomen or upper thigh) which then needs the blood supply to be reconnected somewhere near the breast.  In some severe cases of radiotherapy damage the best solution may even be to replace the whole breast with tissue from elsewhere.  Given the variety of options available you would be best seeking the advice of someone who appreciates the full scope of both partial and total breast reconstruction.  Good luck with it all!

Thank you for your question. The short answer to the question of whether or not you can have breast reconstruction after a lumpectomy and radiation is yes!
Many lumpectomy patients believe breast reconstruction is only possible after mastectomy, but this could not be further from the truth. There are a couple of options for reconstruction post-lumpectomy:
If you're happy with the volume of your breast that has undergone the lumpectomy, it's possible to have the breast re-shaped so that the deficit is "filled in." You may desire a balancing procedure to the other breast, such as a reduction and/or lift, to address asymmetry between the two.If you're not happy with the lumpectomy breast's volume, then fat grafting can be done to restore the volume lost. Fat grafting involves liposuction from one part of the body (typically from the flanks, abdomen, and/or inner thighs), the purifying of that fat, and the injection of that fat into the area of deficit.
Best of luck to you!

Yes- there are different options for lumpectomy reconstruction either with using your own tissue nearby or symmetry procedures depending on each patient's history

Unfortunately, surgical options are very limited following lumpectomy and radiation.  This treatment course often leaves the breast with a focal deficit and with some distortion of shape and nipple position.  Surgery on a radiated breast is risky due to the effects of radiation and options for filling in the focal deficit are quite limited.  It is possible that these options may be improved if fat grafting (moving fat from an area of excess to the area of deficiency) is found to be safe, but this option remains questionable at this time.