Breast Reconstruction After Radiation?

You ask an excellent question. There is some controvery on how to approach breast reconstruction when radiation therapy (XRT) is required. Radiation therapy is excellent in helping you reduce your risk for recurrence. This is the most important thing. As I tell my patients, radiation is excellent at killing microscopic cancer cells. However, radiation does "fry" the non cancer normal tissue as well. Radiated tissue will never be the same. Although some notable studies... more

Reconstruction of the breast tissue after medical radiation is challenging problem. It sounds like your expansion part has been completed and now your surgeon is planning on putting permanent implants which will be exposed radiation. Traditionally it is recommended to use own tissue in addition to implants, if necessary, in patients with exposure to medical radiation. Lately, many surgeons use expansion and implants even in cases of radiation. The muscle flaps are usually... more

The management of breast cancer with radiation causes a lot of concerns when an implant is in the field of radiation. There is a high risk of capsular contracture in implants that have been radiated or are in an area that has been radiated. It sounds like your implant size is appropriate but the radiation may give you some problems. Best Wishes.

Given your size 415cc implants should end up with you being a C cup. This will depend a bit upon how thick your mastectomy flaps are. Also the fact that you will require radiation could effect your final result. Patients that get radiation have a higher incidence of capsular contracture or firmness around there implants. This sometimes can require further surgery to adjust the implant pocket. Your surgeon will be an excellent source of information in this regard. Good luck with your... more

Breast reconstruction following mastectomy with post-mastectomy radiation can present a challenge. In general, plastic surgeons prefer to use a woman's own tissue when reconstructing a radiated breast. In this case, the tummy (or abdominal donor site) may be a good option. Using advanced microsurgical techniques referred to as the DIEP flap (deep inferior epigastric artery flap) extra skin and fatty tissue from the lower abdomen can be transferred to the breast. ... more

Radiation can cause multiple problems in reconstruction of a breast after mastectomy.  The skin is often firm and lack flexibility to be expanded and may result in problems with infection, displacement and extrusion of the expander or the breast implant that replaces it. For these and other reasons, I feel that flap reconstructions, using your own tissues are superior. These techniques for breast reconstruction include TRAM flaps and free flaps, DIEP flaps  among others.... more

Radiaton and implants often have many problems like capsular contractures and healing problems. As for the volume it is hard to predict what is best for you without an exam.

I would suggest that you discuss the possible risks of breast reconstrucion surgery with your plastic surgeon in detail. You may want to know that many plastic surgeons recommend that implant reconstruction be reserved for women who have not had radiation. This is because the incidence of complications after breast reconstruction with implants for women who have had radiation is extremely high. Even without radiation, the chances of needing an unplanned reoperation after implant... more

It is hard to predict a cup size because each manufacturing company can have different sizes.  Given your height and weight,415cc seems appropriate.. Although many patients get implant-based reconstruction in the setting of radiation, radiation can give high risks for capsular contracure and wound healing problem.  You should review all limitations and risks of surgery with your plastic surgeon.

There are no absolute or proven methods to minimize the potential adverse effects of radiation on a reconstructed breast other than the dose and technique of radiation. There have been some doctors who recommend the use of free radical scavengers (anti-oxidants) but controversy exists regarding the therapeutic benefits of the radiation. The 415cc implants should be able to achieve a C cup but I would urge caution in selecting a large implant. Your tissue expander volume should give you an... more

Dear Hhwt2e, Regarding - "The doc said he will be putting 415 cc's. ...following the surgery I will have 5 weeks of radiation on the left breast. I would like to know everything I need to know to offer me the best results for the radiated side." There is not much we can say or do at this point after having had mastectomies, expanders and post op expansion. It is YOUR SURGEONS' (both General and Plastic) duties to answer your question (I would like to know everything I need to know to o more