Mastectomy and Reconstruction Following Radiation

asked 1 year ago by bsimp in Oakland, CA
Latest answer by Paul Albear, MD
Question viewed 352 times
Tags: nipples, silicone implant, healing, lumpectomy, mastectomy, radiation

I had a lumpectomy and radiaiton 18 years ago and 9 years ago (first left, then right breast).1 year ago I was genetically tested and carry the BRAC1 gene. I had a full hysterectomy 9 years ago. Now I am considering a mastectomy and reconstruction. My breast doctor and plastic surgeon both feel I am a candidate for nipple saving mastectomy and immediate silicon implant. I am very small breasted, have no obvious evidence of radiation, and heal well. I am still fearful of healing due to radiation.

6 answers to Mastectomy and Reconstruction Following Radiation

Radiation and reconstruction

I would also have concerns. Once radiated always radiated is what I was always taught. Having a lot of experience with nipple sparing reconstruction, I would be concerned of healing in the area between the nipple/areola and the incision. The removal of the breast tissue will challenge the blood flow . The one caveat being that it has been a long time , but be vigilante of skin changes and keep in contact with your BC Plastic Surgeon.

Paul Albear, MD
Tampa Plastic Surgeon

www.albearplasticsurgery.com

Breast reconstruction after radiation therapy

With regard to an implant reconstruction, prior radiation therapy may increase the risk of capsular contracture, though placement of the implant beneath the muscle and using Alloderm as part of the reconstruction may help. Many other surgical factors (for example mastectomy flap thickness) may also play a role. As part of your discussions with your plastic surgeon, you may wish to ask what long term outcomes (at least 5 years) your surgeon has had with the proposed treatment, as... more

Craig S. Rock, MD
Houston Plastic Surgeon

Radiation and breast reconstruction

While there is a higher risk of capsular contracture with implants and radiation, it does not mean you are destined for failure. The other issue of healing from mastectomy and immediate reconstruction in the face of previous radiation is a function of things beyond radiation (i.e. thinness of flaps, size of breast, size of implant, location of scars, etc.). When planned well, risks are minimized, and you can certainly have a successful outcome. One option is to have expanders availabe... more

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

You multiple options

You past history of radiation will increase risk of capsular contracture. The other options that may work for you is using your abdominal tissue or inner thigh for breast reconstruction. The implant reconstruction has faster recovery and shorter surgery time, but high risk of contracture. Autologous reconstruction has longer recovery and surgery time. You can discuss your options with your surgeon.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon

Breast reconstruction with implants works well in most women with previous radiation.

Hi. This really has to be carefully individualized after physical exam. But particularly with small breasts you should do fine. It's true that there are somewhat increased risks after radiation. But every option has risks. You have increased risk of a new breast cancer if you don't have the mastectomies and an entirely unacceptable outcome for your body image and your appearance if you have mastectomies without reconstruction. The other... more

George J. Beraka, MD
Manhattan Plastic Surgeon

Radiation effects and Breast Reconstruction

I appreciate your concerns about the effects of radiation and breast reconstruction. This remains a problem for plastic surgeons and patients. It sounds like you have the information you need regarding your options. I am sure your surgeons will do their best to decrease your risks of complications, but go into it prepared. Hopefully you will heal well and not have any problems, but if you do you may need additional surgery. Your surgeons will discuss this with... more

Albert Dabbah, MD
Boca Raton Plastic Surgeon

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