Breast Reconstruction: Q&A
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How Long After Radiation Should I Wait for Expansion Process and DIEP Flap Reconstruction?
I had a bilateral mastectomy with insertion of tissue expanders at same time followed by 25 radiation treatments to my left breast and chest wall area. Radiation treaments finished on December 27, 2011. How long should I wait before (1) saline expansion and (2) DIEP flap reconstruction can safely take place? Am not in a hurry. I care only about safety and having a successful outcome. Thank you.
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6 Doctor Answers |
Asked by
GinnieLee
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DIEP Flap Breast Reconstruction after Radiation
I typically prefer to wait 6 months after radiation therapy to consider diep flap breast reconstruction. Radiation does not only damage the skin, but the underlying muscles and blood supply.
As microsurgeons, we want to ensure that the blood supply has had a chance to recover from radiation, such that we can safely reconnect the blood supply of your diep flaps. We typically use the skin as a guide to what is underneath. Hence, if your skin...
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Surgery timing after radiation
It is debatable whether or not saline expansion can ever be performed safely after radiation, because of the high rate of complications associated. Flap surgery may be a better option and typically a wait of 3-6 months or more may be warranted depending on the degree of inflammation and swelling present after the radiation. Consultation with a plastic surgeon who offers both types of surgery is recommended.
Daytona Beach Plastic Surgeon
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Radiation and tissue expansion.
Tissue expanders placed immediately at the time of the mastectomy with the intention of exchange to DIEP flaps is fairly regular practice to limit the amount of skin replacement necessary if radiation is needed. Expansion post radiation can begin as early as 2 weeks after the radiation. Much of the timing is dependent upon the clinical impact of the radiation to the skin flaps (erythema, hyperpigmentation, dermal edema), the degree of expansion needed, and the overall thickness of the flaps....
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See two or more board-certified plastic surgeons to be sure you are a good candidate for the DIEP flap.
Implant-based reconstruction with implants/expanders has a very high rate of complications after radiation therapy. It is customary to wait 6-12 months to perform tissue reconstruction to let all of the inflammation associated with radiation subside.
See two or more board-certified plastic surgeons to be sure you are a good candidate for the DIEP flap.
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Tissue expansion and DIEP flaps after radiation
Tissue expanders have a much higher complication rate in the face of radiation. Usually if a TE is used, it should not be expanded until 4-6 weeks after RT is complete. DIEP flaps can be done about that same time after RT if it is being performed as a delayed reconstruction.
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How long after Radiation can reconstruction begin?
I would tell you that I typically tell my patients wait 6 weeks. I would tell you that saline expansion is not a good idea in the face of radiation, lots of complications and usually fails. DIEP flaps are an excellent method of reconstruction in the face of radiation. Make sure your surgeon offers both , is BC in PS and good luck in your reconstruction process!!
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