I had a right breast mastectomy, chemo, and radiation for breast cancer that included lymph node involvement. I am considering a DEIP for reconstruction, but would like to know if there is a typical waiting period after the radiation, and what types of complications are likely?
DIEP After Radiation?
Doctor Answers (6)
How long after radiation can I get a flap for breast recon?
At least 4 months after the complete of radiation is a good rule of thumb. 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
DIEP after Radiation therapy
The minimum you need to wait after radiation is 5-6 weeks, but most people wait at least six months to try and let the skin heal as much as possible. The complications are most certainly higher after XRT, but it often depends on other factors such as your weight and other health issues.
DIEP after radiation
I typically wait until the acute changes in the skin have resolved, usually 4-6 months. The shape of the reconstructed breast is often different from the opposite breast after radiation. In addition, most patients will need some skin replaced with the flap, which can affect the appearance of the breast. The radiated skin is often more swollen and firm to touch. Wound healing complications in the breast are more common after radiation.
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You can have a DIEP flap after radiation and chemotherapy.
IN many cases you have an redness that is present for several weeks after radiation. If this resolves quickly and the skin is loose I would see you and see if you could have surgery earlier to use the remaining skin. If the skin was sacrificed at the time of surgery then the timing can be decided up other factors.
Radiation and DIEP flaps
Radiation may impact the vessels that are used when restoring blood supply to the DIEP flap in the chest. There is no specific time that will make it perfect. usually you want any skin changes to subside. However, the vessels may not be good and one may not find out until the exploration of them.
Post Radiation Breast Reconstruction
I generally recommend autologous (using your own tissue) reconstruction after radiation therapy. A DIEP flap is an excellent procedure. I generally recommend waiting about 6 months after radiation to consider DIEP flap reconstruction. If the radiation changes (redness or firmness of skin) persist at 6months, it is wise to wait longer - up to 12 months. Please visit with a board certified plastic surgeon experienced with DIEP flap reconstruction to learn more about your options.
Web reference: http://www.diepflaphouston.com
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.
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