Breast Reconstruction: Q&AAsk a Question
8 Doctor Answers | Asked by 234 in Indiana
Breast reconstruction after lumpectomy is becoming increasing common as breast conservation in the face of breast cancer becomes more sophisticated. Many times lumpectomy defects can be very challenging to reconstruct. The first issue involves whether you have had radiation. Irradiated breasts are more common in people who have had lumpectomies and make reconstruction more complicated. Typically radiation will require the usage of "autologous" tissue (meaning your own). The...
The most important component in the decision making is whether you have undergone or will undergo radiation therapy. Radiation may affect your current breast implant and may further compromise your candidacy to undergo reconstruction with a prosthesis (tissue expander or implant). Depending on the amount of radiation received, you may be a candidate for breast reconstruction using your own tissue. Examples of these muscle flaps include the rectus muscle and latissimus muscle. Recently, a...
Depending on the degree of the deformity, there are several options including utilizing local tissue rearrangement with or without additional tissue which may include the use of a dermal implant such as Alloderm, replacement or revision of your implant reconstruction, and finally the use of autologous (your own body) tissue from another site such as your back or abdominal areas. A consultation with a Plastic Surgeon is the best place to start.
Fat grafting has become a popular procedure to improve aesthetic outcome following breast reconstruction or for improvement of contour after lumpectomy. Much of the newest research has investigated the properties of fat, in terms of its stem cell properties and associated advantages. At our Breast Reconstruction Center, we have utilizing this technique almost routinely to maximize the aesthetic outcomes after lumpectomy or mastectomy. We have utilized the micro-fat grafting...
If you have not had radiation then the tissue can be rearranged to close the defect and improve the overlying contour. If you have had radiation then I would recommend filling the space with your own tissue from another location. The reason is that radiation reduces blood flow, and increases the chance of complications if radiated tissue is cut.
Defects after lumpectomy are common and a good reason to consult a plastic surgeon. There are many options, but the solution will depend on the severity of the issue. Juvederm is not a good choice for breast reconstruction because it will not last. Local tissue rearrangement, fat grafting, or using a portion of muscle from another part of your body are all possible choices. This is where the clinical exam and the expertise of the plastic surgeon come into play. You can discuss your options...
Lumpectomy often results in the indentation that you describe. The problem is that every lumpectomy leaves you with a unique situation! It is thus very difficult to answer your question here as there are so many individual questions that need to be asked? How big is the indentation? Where on the breast is it located? Did you have radiation to the breast? Was the implant placed before the lumpectomy or as part of a reconstruction? All of these questions influence how a repair can be...
There are many different ways to reconstruct deformities of the breast after lumpectomy. Usually this requires one of several options: either using local tissue (i.e. the remaining breast itself) or recruiting tissue adjacent to the breast or even from a remote location( Latissimus muscle flap, ICAP flap, DIEP flap, TRAM) to improve the contour. It really depends upon how severe the defect is.