Double Mastectomy with Immediate Reconstruction and then Radiation - Timeframe for Expanders?

asked 1 year ago by nataly in California
Latest answer by Loren Schechter, MD
Question viewed 1,148 times
Tags: age 35-44, A cup, expander, radiation, timing

I am 38 years old diagnosed with breast cancer,had chemo before surgery and I am going to have a double mastectomy with immidiate reconstruction the problem is that i need radiation too ,i have to start rads 6-8 weeks after surgey.I am very small chested(A cup,0 body fat) but i definetly want to go bigger, I was wondering if 8 weeks is enough time to get expanded?What cup will i be in 8 weeks? If i go with one step procedure with alloderm is better than tissue expanders?

11 answers to Double Mastectomy with Immediate Reconstruction and then Radiation - Timeframe for Expanders?

Breast reconstruction and radiation

In general, for women undergoing post-mastectomy radiation therapy, it is preferable to use her own tissue. This tissue may come from the abdomen (diep flap), thighs (tug flap), buttocks (sgap flap), back (latissimus or tap flap).

Loren Schechter, MD
Chicago Plastic Surgeon

Radiation Is The Wild Card In Breast Reconstruction

Anytime a woman definetely needs radiation after their mastectomy, and this is known beforehand, the decision to perform immediate breast reconstruction must be thoroughly understood. Radiation can cause a number of issues to a breast reconstruction, and about 1/2 the women that have an expander and get radiated will need some sort of "salvage" procedure with their own tissue due to the radiation effects. Patients need to be aware of this when undergoing an expander in... more

Christopher V. Pelletiere, MD
Barrington Plastic Surgeon

Breast reconstruction and radiation

As has been said here by many of the other surgeons, radiation can have deleterious effects on the final outcome of reconstruction. However, it is highly variable, depending on the dose of radiation, preop size and shape of the breast, and the amount of tissue remaining between the skin and the muscle layer. I prefer a two-stage process with initial use of Alloderm, which allows for faster expansion prior to radiation, and a tissue expander placed at the first stage. I expand as... more

Tim Abou-Sayed, MD
Palm Beach Plastic Surgeon

Double Mastectomy with Immediate Reconstruction and then Radiation - Timeframe for Expanders?

I wish you a speedy recovery. With that stated, I believe it is possible to expand to a B cup with twice weekly sessions. As for the Alloderm, et al options very hard to advise without in person evaluation. But a great idea. From MIAMI

Darryl J. Blinski, MD
Miami Plastic Surgeon

Radiation and expanders?

If you are definitely getting radiation, you may want to opt for a delayed resocntruction because tissue expanders and implants during radiation usually do not turn out too well.

Steven Wallach, MD
Manhattan Plastic Surgeon

Double mastectomy with need for radiation- timing for expansion

If you want to go bigger than your current A cup, you will have more control over the final size with a two stage reconstruction (expander then implant) than a one stage reconstruction (straight to implant). The size that you will be after expansion depends on how much fluid can be added to the expander each week after the expanders are placed, and each patient is different. You are right, that once radiation starts, expansion has to stop. After the radiation is completed, it impossible to... more

Nia Banks, MD, PhD
Washington DC Plastic Surgeon

"Direct to implant reconstruction resists radiation"

I am so sorry to hear of your condition.It has been recently published by my group that the use of immediate reconstruction and acellular dermal matrix (Alloderm) may reduce problems after radiation therapy and capsular contracture. My patients who want to be slightly larger now go directly to an implant avoiding expanders and get radiation after. We have no one who has developed contracture. Hope this helps....

C. Andrew Salzberg, MD
Westchester Plastic Surgeon

Breast Reconstruction

There are many issues to be considered here and it seems that you need more explanations before the surgery. My advise is to sit with your plastic surgeon ( You need an hour to an hour and half) to discuss your situatio. Your plastic surgeon should talk with your breast surgeon, oncologist and radiation therapist. Then meet with you again and dicuss what they all feel is best for your condition. Then what are the options for you in breast reconstruction Make a list of your... more

Samir Shureih, MD
Baltimore Plastic Surgeon

Tissue expanders in breast reconstruction

The fact that you are getting a mastectomy plus radiation suggest a large or aggressive type of cancer. The answer you seek is not a simple nor easy one. There are different philosophies and aaporaches and no specific "right" answer. It also depends on what body type you have and the surgery required. Certainly a "spacer" is a good idea as a first stage. Whether this is a temporary implant or an expander depends on the nature of the remain skin and the ultimate final goal... more

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Tissue expansion after radiation

Your question is extremely good, and important. It's likely you could be expanded enough prior to radiation (as long as there are no significant postoperative complications). I'm not sure what you mean by a one step procedure, unless it is Alloderm and an implant. This can work, but the implant doesn't stand up as well to the tightening forces of the radiation as the expander does. I usually use Alloderm in my expander reconstructions as well, and this should also allow for... more

Verne Weisberg, MD
Portland Plastic Surgeon

www.drverne.com

Bilateral Mastectomy, immediate reconstruction and radiation

Immediate prosthetic breast reconstruction is frequently done in a 2-stage fashion with initial tissue expanders and subsequent implants. Some plastic surgeons may utilize direct -to -implant reconstruction without the use of tissue expanders in some cases. AlloDerm may be used in prosthetic reconstruction in both 2 stage and 1 stage procedures and may allow a shorter expansion time and achieve a reasonable breast mound shape in a shorter time frame... more