Can Fat Grafting Be Safely Performed in DCIS After Lumpectomy and Radiation?
- Asked by einarsen
- 11 months ago
I had DCIS, lumpectomy and rads in 2008. In 2011 I had tissue expanders and exchange after six months of painful expansion. Six weeks later the wound opened on the cancer breast and I had implants removed. Over one year later, and after a total of four and a half post rads, and the breast has shrunk more and also develped spider veins/ugly red spots at the tumor spot. Can fat grafting fill in the divot and is there a higher risk of recurrence in DCIS patients?
Fat grafting after Lumpectomy?
Yes fat grafting can be safely done after lumpectomy and radiation. It should be done in small increments and allow enough time (at least 4 months). The blood supply is the key to successful fat grafting.
Fat grafting is safe
Thank you for your question. I'm sorry for your trouble. I know that it is very frustrating to go through cancer treatment and then have complications. Fat grafting can be used in the treatment of postlumpectomy defects. The latest literature has shown that imaging can distinguish injected fat from breast tissue. This needs to be done by an experienced Board Certified plastic surgeon. If too much fat is injected, it can lead to fat necrosis and palpable nodules. The inherent problems with fat injection in this scenario are that the radiation diminishes the elasticity and ability of the overlying skin to stretch. In some patients the fat is not "strong enough" to push the skin back out. Sometimes we couple mobilizing the adjacent breast tissue along with the injection of fat to fill these defects. These are tricky though. Best of Luck!
Fat Grafting following lumpectomy and radiation
Typically, fat grafting can be utilized to add volume in resulting concavities following a lumpectomy or mastectomy. This being said, sometimes following radiation sequaele can be left for the patient to deal with such as skin pigmentation, altered skin elasticity, altered vascularity, and fat necrosis resulting in asymmetry and dissatisfaction to be dealt with. The skin has a decreased blood supply and therefore you might retain less of the fat that is being placed. Typically the fat is put in contact with healthy tissue with the premise to create its own blood supply. With a potential alteration in vascularity, the fat retention could be diminished as well. You could possibly require serial sessions of fat grafting which would be determined during your consultation. It is an outpatient surgery with minimal down time, therefore patients typically do not have a problem with this. It is important to set up a consultation with a Board Certified Plasic Surgeon who specializes in breast surgery and is well versed with latest advancements of the fat grafting technique.
I hope this helps you and good luck
Fadi Chahin MD, FACS
Plastic and Reconstructive Surgery
Diplomat, American Board of Surgery
Diplomat, American Board of Plastic Surgery
Recent Breast Reconstruction Reviews
Breast Reconstruction Photos
Can fat grafting be done in lumpectomy defects after radiation treatment.
So far the latest information from the ASPS states that there is sufficient evidence after mastectomy to support the use of fat grafting. Lumpectomy defects are different and DCIS is not invasive cancer. It would be best to speak to your breast surgeon about your concerns and have them refer you to a reconstructive plastic surgeon. If one is not available in your area use the interet to search for the nearest Board Certified Plastic Surgeon who devotes significant time and effort to reconstrucive surgery of the breast.
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.