some residual soft skin on left. Height 177cm. Weight 115kg. Had hysterectomy.do not want a flap procedure. can expansion be considered? thank you
I Am a 55 Yrs Old. Double Mastectomy with Radiation on Left Side.
Doctor Answers 7
I am 55 yrs old - double mastectomy with radiation on left side
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!
Breast Reconstruction after radiation
Post-radiation expander reconstuction may work
Radiation damages the skin and makes it less pliable and less resistant to infection. However, not every breast is similarly affected. If you do not want a flap, try an expander reconstruction. You may have to compromise the "perfection" or softness of the result, but you will gain in simplicity.
Get the advice of a good surgeon whom you like.
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Tissue expander breast reconstruction after radiation usually works.
We do this frequently, and with low complication rate. The condition of your soft tissues (skin and muscle) is important, and you need to find a really experienced plastic surgeon.
Radiation and tissue expanders
Although placing expanders after radiation can be performed. It all depends upon the quality of the tissues. You have to also understand that the risks for infection and wound complications are higher with the radiated tissue.
Breast reconstruction after radiation
I agree with Dr. Jenson, you have a higher liklihood of complications on the radiated side with expander/implant reconstruction alone. Your best bet is a latissimus flap over expander/implant. This places healthy ,well- vascularized tissue over the implant and takes some of the strain off of the radiated mastectomy skin.
All my best,
Daniel A. Medalie, MD
Radiation and breast reconstruction
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.