Breast Reconstruction: Q&A
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Risks of Breast Reconstruction with Implants After Radiation Therapy?
I have recently had a bilateral mastecomy due to breast cancer in my left breast. I am currently undergoing chemotherapy and will be having radiation therapy. There is much conflicting information about whether breast reconstruction with implants is recommended or even feasible after radiation therapy.
I have had multiple surgeries previously, and I am concerned about having multiple surgical sites (such as those from TRAM or DIEP procedures). What are the risks of utilizing breast implants after radiation, and how long should one wait to have the implants to minimize risk (if possible to do so)?
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11 Doctor Answers |
Asked by
Victoria1234
in Tampa, FL
+2
Implant Breast reconstruction following radiation
Although the risks are greater using implants following radiation, very good results can be obtained. Generally one should wait until the initial reaction to the radiation has subsided, but not so long that subsequent severe scar reaction has occurred. Results are also better if you had significant tissue and the skin was relatively loose after the mastectomy. Also, since you have had a bilateral mastectomy, your results will usually be better than someone with a unilateral mastectomy,...
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Highlands Plastic Surgeon
+2
Radiation treatment and breast implants
There are many reports that show that placing implants in a radiated bed leads to very poor results. The best treatment is to provide autologous tissue to reconstruct this region.
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Implant breast reconstruction after radiation
There is a very high, some say almost 100%, risk of capsular contracture with an implant reconstruction after radiation therapy. It is not that you can't give it a try, but at the first sign of the tissues not expanding, I would quit with this mode. Pushing farther will only lead to problems. I have taken care of far to many patients who have come to me after multiple attempts at this, all of which were either failures or where the results were so hard that they were worse than not...
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Implant Reconstruction and Radiation
There is some controvery on how to approach breast reconstruction when radiation therapy (XRT) is required. Radiation therapy is excellent in helping you reduce your risk for recurrence. This is the most important thing. 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...
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Breast implants reconstruction after radiation
The use of breast implants in breast reconstruction after radiation has a high rate of wound complications(delayed healing, implant exposure) and capsular contracture. If an implant is anticipated you would probably go with an expander first, going through very slow expansion.
Another option would be a latissimus dorsi flap with an expander or implant.
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Radiation therapy and implant reconstruction.
There is no doubt that there are increased risks of complications with implants following radiation therapy. This does not mean that it should not be done but that you should be aware of this. Clearly you have an understanding as is indicated by your mention of the autologous tissue flaps which are generally preferred with a history of radiation. There are conflicting reports about the timing, some studies suggest within 6 weeks while others advise waiting 3-4 months. In any situation, you...
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Post-mastectomy radiation therapy and breast reconstruction
Although a beneficial adjunct for breast cancer in several circumstances, radiation therapy (RT) has also detriments to both the patient as well as plastic surgeon in breast reconstruction. Above all, treatment for cancer comes before the aesthetics of breast reconstruction, and the proven benefit outweighs the ill-effects of RT. The impact that RT has on the skin, as evidenced by the radiation dermatitis/radiation burn, angiofibrosis, contrcture/fibrosis of the skin, and soft tissue, as...
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Possible, but best to consult with both your oncologist and reconstructive surgeon
Breast reconstruction is not a one-size-fits-all procedure. The timing and technique best for your specific breast reconstruction case will be highly influenced by the amount of healthy, natural breast tissue you have after your mastectomy as well as the elasticity of your skin.
Because you also mention previous surgeries, the presence of existing scar tissue may also influence your procedure. It is possible to undergo breast reconstruction with implants after chemo and...
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Understanding Implant Risk after Radiation
Breast implants placed after radiation have a higher risk of infection. There is the potential for loss of the implant or scar tissue, capsular contracture, and pain. If possible, the preferred approach is to have tissue expanders placed at the time of mastectomy and prior to any radiation therapy. After radiation, if there are no implants or tissue expanders in place, the surgeon typically would wait 3 to 12 months prior to attempting implant surgery. The waiting period depends on the...
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Implants for Reconstruction After Radiation
When radiation is used in the treatment of breast cancer, non-cancerous tissues in the path of the radiation are also affected. Radiation therapy can mean a significant loss of skin elasticity, which can profoundly affect the aesthetic results of breast reconstruction. And because the body’s wound-healing mechanisms are altered by exposure to radiation, complications from all types of reconstructive breast surgery occur at a higher rate.
Even in the absence of radiation, the...
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Radiation and breast implants in reconstruction
Clearly, there is substantial data that the administration of radiation to the breast/chest wall AT ANY TIME IN THE PATIENT'S LIFE is associated with an increased risk of capsular contracture if the patient has implants placed. By that I mean that even patients who had prior lumpectomy/radiation and are now coming for completion mastectomy may be at increased risk for radiation-related capsular contracture around implants even though the radiation preceded the implant placement....
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