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Reconstruction after mastectomy and radiation

asked 7 months ago by Golden lover in Arvada, CO
Latest answer by J. Jason Wendel, MD
Question viewed 157 times
Tags: age 55-64, female, lymph node, prosthesis

I had a right mastectomy in March of this year and was planning on having immediate reconstruction; however, one of the lymph nodes had a tiny bit of cancer in it so they did not do that. I did have radiation and completed that in June, but did not require chemotherapy. I am planning on having a TRAM flap and having my left breast reduced and lifted to match the right one (I wanted to be smaller). Would it be reasonable for me to plan on having this done next March or April? I have been very diligent about putting Aloe gel on my radiation site, am getting my strength back (even stopped working to speed my recovery) and am working out about 4 times a week (I'm 57). I want to get this done and move on with my life. I am VERY self-conscious about going out with the "one breast" and wear big shirts to camoflauge, and only wear the bra & prosthesis when line dancing as it is very uncomfortable. I would appreciate any help you could give me - thank you! Pam Murchison

9 answers to Reconstruction after mastectomy and radiation

Breast reconstruction after radiation

To answer your question directly, I typically wait 12 months after the completion of radiation to perform breast reconstruction. You had mastectomy in March 2011 but when did you finish radiation? Discuss the timing of your restruction with your plastic surgeon. When it comes to radiation, waiting the required amount of time, can make a big difference in getting a favorable result. I know you want to get it done and move on but you also don't want to get a substandard result either. more

J. Jason Wendel, MD
Nashville Plastic Surgeon

www.mc.vanderbilt.edu

Breast Reconstruction After Radiation

There is some controvery on how to approach breast reconstruction after radiation therapy (XRT). Radiation therapy is excellent in helping you reduce your risk for recurrence. As I tell my patients, radiation is excellent at killing microscopic cancer cells. However, radiation does "fry" the non cancer normal tissue as well. Radiated tissue will never be the same. Although some notable studies have shown acceptable results with implant-based reconstruction in patients who... more

C. Bob Basu, MD
Houston Plastic Surgeon

www.basuplasticsurgery.com

Delayed breast reconstruction after mastectomy and radiation

Adjuvant radiation after mastectomy is a vital part of our armentarium in adequately treating breast cancer. Numerous studies have shown that in certain patient groups locoregional recurrence can be reduced and survival increased. However, it has also been clearly shown that radiation has a detrimental effect on immediate breast reconstruction outcomes regardless of whether a tissue expander or flap are used. Thus, most plastic surgeons prefer to perform delayed... more

Kelly Gallego, MD
Sioux City Plastic Surgeon

Please get your reconstruction.

It sounds like you have been very diligent about your exercise and care to the radiation site. I also must acknowledge how difficult it must have been for you without any form of breast mound while you underwent radiation. By this point you should be more then ready for your reconstruction. As long as the skin is healed and you desire reconstruction please do it. I do think that using your own tissue after radiation is better then using an implant. TRAM flap is... more

Kari L. Colen, MD
New York Plastic Surgeon

www.colenmd.com

Radiation injury and breast reconstruction

I think the key to reconstruction after radiation is to evaluate the soft tissues. If they are soft and do not have any radiation inuury appearance than it is probably safe to pursue reconstruction. However, you have to be aware that the bllod supply to the irradiated field is still compromised and may impact the final result.

Steven Wallach, MD
Manhattan Plastic Surgeon

Optimizing reconstruction results after radiation

A quick check list that I recommend: 1. Moisturize skin 2x daily with Calandula Lotion 2. Build up to 50 sit-ups per day to increase blood flow to rectii. 3. NO SMOKING OR SMOKE FILLED ENVIORMENTS!! 4.Ask your surgeon about taking calcium channel blockers

Barry H. Dolich, MD
Bronx Plastic Surgeon

Breast reconstruction after radiation therapy

Once you have healed up from the radiation therapy, and are in good health, then you can have the breast reconstruction. Most individuals are more than healed a year after their mastectomy and radiation treatment. I would recommend going with either a TRAM flap reconstruction or other form of autologous tissue reconstruction such as Latissimus dorsi flap. Both procedures give excellent results with very natural looking breasts. By lifting and reducing the other... more

Robert M. Jensen, MD
Medford Plastic Surgeon

Reasonable plan

I have patients wait at least 6 months post radiation therapy before any surgery and I almost always include autologous tissue (tram or latissimus flaps). Best wishes to you.

Mark D. Wigod, MD
Boise Plastic Surgeon

Breast reconstruction following mastectomy and radiation

For many women who require post-mastectomy radiation therapy, autogenous reconstruction is the preferred method. There are several options from from where tissue can be moved from one part of the body to the breast. The abdomen represents one of the most common "donor sites." The TRAM flap (or transverse rectus abdominus flap) is an older method of breast reconstruction. Technical advancements have allowed surgeons trained in microsurgical techniques to... more

Loren Schechter, MD
Chicago Plastic Surgeon

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