Is Reconstruction Without Moving Muscle Possible After Radiation for Breast Cancer?

Is reconstruction possible without the need to move a muscal (flap) after radiation for breast cancer? Thanks Vic

Doctor Answers (6)

Is reconstruction without moving muscle possible after radiation for breast cancer?

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Hello!  Thank you for your question.  After radiation, you have an increased rate of complications including wound problems, infections, thinning of the tissue, and decreased vascularity to the skin/tissue of the area.  The best method to reconstruct a breast following radiation therapy is with a flap.  The flap, which is skin, fat, and sometimes muscle, will serve to bring in healthy, well-vascularized tissue to the chest/breast area that will significantly ameliorate the radiation issues compounding the problem.  Microsurgical perforator flaps (such as the DIEP flap and SGAP/IGAP flap) are the newest and most-innovative procedures in breast reconstruction today.  As these are muscle-sparing flaps, the pain, morbidity, and complications such as those above, of these procedures are much less.  They are highly-complex procedures that few plastic surgeons performed and consult with one who is well-versed, trained, and skilled in these procedures if you are interested.  

There are many options to breast reconstruction including implant-based and flap-based procedures.  The complication rate with implants following radiation is reported as high as 60-70% in some studies.  Flap reconstruction is usually recommended, but there are several centers who perform implants following radiation with great success and results.  I typically prefer flaps, such as the DIEP flap.  Other flaps are the conventional TRAM, latissimus flap, SGAP/IGAP, and, TUG.

You are a candidate for other procedures, if you are willing to continue with your journey for a reconstructed breast.  Flaps such as those above, including others, are available.  The decision to continue with this will be your decision and what you are willing to go through.  There are risks and benefits with everything that we do in Surgery - discuss the various options with a board certified plastic surgeon who will educate you on all of the options and help you to decided if breast reconstruction or which procedure will be best for you.  Hope that this helps and best wishes!


Scottsdale Plastic Surgeon
5.0 out of 5 stars 11 reviews

Breast Reconstruction After Radiation

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Thank you for your question.

Breast reconstruction can either be achieved by using your own tissue (skin/muscle flap) or by using implants. Generally reconstruction using your own tissue is preferred following radiation because radiated skin is much less reliable and more likely to have complications than non-radiated skin. This is especially a concern when there is an implant under the skin because if the skin breaks down and the implant becomes exposed or infected additional surgery is required to remove/replace the implant.

To determine what type of reconstruction you are a candidate for visit a Board Certified Plastic Surgeon.

I hope this helps.

Do I need to have a muscle flap for Breast Reconstruction after Radiation?

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There are several types of flaps that are utiulized today that don't involve the movement of muscle.  Perforators flaps are flaps composed of skin and fat and the blood vessels that provide flow to this area.  DIEP flap is commonly used to perform a total breast reconstruction after mastectomy.  Other flap such as the SGAP and SIEA also utilize skin and fat.  Another popular method for thinner patients is the TUG flap but this requires a small muscle sacrifice in the inner thigh area.  If you search for a DIEP flap surgeon in your are then you will most likely get someone who can speak about all of these options easily as well as others.

Fat grafting is a valuable tool in breast surgery. This technique has gained more popularity over the past 7 years. There are many techniques used to harvest the fat, process the fat and then re-inject the fat. Conventional suction lipectomy is performed with a small diameter cannula, processed by separating the liquid and fibrous tissue from the fat, and then placed into syringes for re-injection or through a closed system.

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Reconstruction after radiation for breast cancer

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can be done in several ways.  You should see a plastic surgeon who specializes in microsurgical reconstruction for options that would not require muscle flaps.  He/She could also educate you on the possibilities using other modalities such as expanders and fat grafting.  Best wishes!  If you were in my neck of the woods, California Pacific Medical Center is where I would suggest you check.

Curtis Wong, MD
Redding Plastic Surgeon
4.5 out of 5 stars 16 reviews

Is Reconstruction Without Moving Muscle Possible After Radiation for Breast Cancer

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It all depends on the quality of the skin

Expansion reconstruction ,either internal or external, can be performed if tissues are sufficient.This may be supplimented with fat and PRP injections

Hilton Becker, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 5 reviews

Breast Reconstruction

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After radiation therapy, the failure rate for implant reconstruction is high.

Best to reconstruct with flaps.

 

Other option to consider is fat transfer for breast reconstruction

Samir Shureih, MD
Baltimore Plastic Surgeon

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.