Breast Reconstruction After Lumpectomy and Radiation?

Isolated defects of the breast secondary to a lumpectomy are nicely improved with fat transfer. This is a procedure I perform in the office comfortably under local anesthesia. See the attached video for a demonstration.  

Although a lumpectomy usually results in a natural looking breast there are times where enough breast tissue was removed or the lumpectomy was in an esthetically unfavorable location and reconstruction is warranted and covered by insurance. The most reliable solutions are symmetry procedures to the non-irradiated breast or transferring tissue to the irradiated breast to "fill the dent." Less effective are fat grafting and placing implants in my opinion.

The short answer is yes: there are lots of options.  In general, rearranging what you have left after radiotherapy and a lumpectomy can give good results, but is relatively high risk for wound healing problems that could leave you worse off than you are already.  Radiotherapy has lots of benefits for cancer treatment and reducing the risk of recurrence.  It also, however, compromises the ability of the breast to heal with further surgery.  The best options therefore tend to depend on whether there is a contour irregularity (like a dent) or a shape problem that you would like corrected or whether the issue is simply a size discrepancy between the two breasts.  If the issue is purely size the simplest options would be to either make the radiotherapy side larger with fat injections or the normal side smaller with a slight breast reduction.  If the issue is a small contour irregularity or some sort of indent at the site of the previous lumpectomy, with or without a small size discrepancy, fat injections may still be a good option.  They often require one or two top up procedures though.  More significant shape or contour issues often require tissue to be brought in from elsewhere.  This can either be done using small tissue volumes from the chest near the breast or from somewhere else further away on the body (like the lower abdomen or upper thigh) which then needs the blood supply to be reconnected somewhere near the breast.  In some severe cases of radiotherapy damage the best solution may even be to replace the whole breast with tissue from elsewhere.  Given the variety of options available you would be best seeking the advice of someone who appreciates the full scope of both partial and total breast reconstruction.  Good luck with it all!