Lumpectomy Reconstruction Options.

I had wide excision lumpectomy and radiation. I am very small busted and thin. The lump was in the lower pole of breast significant hole/gap that is more noticeable when I lift my arm up and down. Is fat grafting the only option or better yet maybe a small implant like 150-200 cc's and if an implant could be used is it impossible to stretch radiated skin or is there a way? What are my options?

Doctor Answers 3

Lumpectomy Reconstruction Options

Thank you for your questions. This is a very important issue that many women deal with during reconstruction. Sometimes after a lumpectomy, the tissue can be rearranged prior to radiation to prevent contour deformities after radiation. Unfortunately, many women are not given this option and end up with a result after radiation that is not pleasing. The problem is, after radiation, the options can be very limited. One option is scar release and fat grafting, but this option can be unpredictable and may require multiple surgeries to get a good result. I also find that the fat take in radiated tissue is less than in healthy tissue. As for implant, pairing these with radiation can be very risky and is something that you should discuss with a local board certified plastic surgeon. Often a specific defect is not improved with an implant because it does not address the specific area of concern. Your best bet is to schedule a consultation with a local board certified plastic surgeon who is experienced in breast reconstruction. This way you can discuss the options that may be available to you.Best of luck!

Lumpectomy treatment

You describe a common problem, especially in women who undergo a lumpectomy in the lower pole of a small breast. For contour irregularities after a lumpectomy with radiation, fat grafting is generally the simplest solution. However, the results can be a bit unpredictable, multiple grafts may be required, and it may not correct skin contour irregularities or scars. Larger contour irregularities or extensive skin scarring may require tissue transfer, such as a thoracodorsal perforator flap or latissimus flap. I would not recommend placing an implant in your irradiated breast, as it is unlikely to improve the contour left behind after a lumpectomy and is potentially subject to complications such as capsular contracture (scar tissue around the implant).

Mark Sisco, MD
Northbrook Plastic Surgeon

Breast reconstruction after lumpectomy/radiation

There are several options for breast reconstruction after lumpectomy and radiation. Release of scar and fat grafting is one option to restore the volume of tissue. If there is significant tissue loss, then reconstruction with tissue expander converted to implants is an option depending on the status of the radiated tissues. Recommend an evaluation by a board certified plastic surgeon. Best, Dr. Yegiyants 

Sara Yegiyants, MD, FACS
Santa Barbara Plastic Surgeon
5.0 out of 5 stars 6 reviews

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