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.  

Thank you for your question. The short answer to the question of whether or not you can have breast reconstruction after a lumpectomy and radiation is yes!
Many lumpectomy patients believe breast reconstruction is only possible after mastectomy, but this could not be further from the truth. There are a couple of options for reconstruction post-lumpectomy:
If you're happy with the volume of your breast that has undergone the lumpectomy, it's possible to have the breast re-shaped so that the deficit is "filled in." You may desire a balancing procedure to the other breast, such as a reduction and/or lift, to address asymmetry between the two.If you're not happy with the lumpectomy breast's volume, then fat grafting can be done to restore the volume lost. Fat grafting involves liposuction from one part of the body (typically from the flanks, abdomen, and/or inner thighs), the purifying of that fat, and the injection of that fat into the area of deficit.
Best of luck to you!

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!

Simple answer is YES! There are many options including fat grafting to thoracodorsal perforator flaps to oncologic breast tissue rearrangement. I would recommend seeing a board certified plastic surgeon to have a consultation to see which options would help you achieve your goals! Good Luck!

Yes- there are different options for lumpectomy reconstruction either with using your own tissue nearby or symmetry procedures depending on each patient's history

Unfortunately, surgical options are very limited following lumpectomy and radiation.  This treatment course often leaves the breast with a focal deficit and with some distortion of shape and nipple position.  Surgery on a radiated breast is risky due to the effects of radiation and options for filling in the focal deficit are quite limited.  It is possible that these options may be improved if fat grafting (moving fat from an area of excess to the area of deficiency) is found to be safe, but this option remains questionable at this time.

Yes! There are many options after lumpectomy. Depending on the what the radiation has done to the local tissues may dictate your options. Autologous tissue flaps, Implants and finally fat transfer are all options that maybe used. The best is to see a board certified plastic surgeon who does many of these types of cases.Hope this helps !

Hello!  Thank you for your question.  Yes - you are certainly a candidate to have reconstruction of your deformity from your cancer surgery.  Fat grafting has become a popular procedure to improve aesthetic outcome following breast reconstruction or for improvement of contour after lumpectomy. Much of the newest research has investigated the properties of fat, in terms of its stem cell properties and associated advantages. It has significantly ameliorated radiation damage by increasing vascularity. Also, it adds additional "fatty tissue" atop the reconstructed breast mound to further contour any concavities or deformities, while also masking implant visibility with rippling and such.At our Breast Reconstruction Center, we have utilizing this technique almost routinely to maximize the aesthetic outcomes after lumpectomy or mastectomy. We have utilized the micro-fat grafting technique, and have been obtaining maximal fat graft survival into the breast. After harvesting of the fat from areas with excess fat, usually the belly, hips, or thighs, the fat is processed and injected back into the breast using the aforementioned techniques. Our patients have been very happy with the results as well as the areas where the liposuction was performed. Contour has been much improved using the micro-fat grafting technique, and the downtime is minimal. Fat grafting has become a mainstay in breast reconstruction and has added another edge to breast reconstruction for aesthetics with minimal morbidity and complications.

The deformity of a breast after lumpectomy and radiation ranges from very mild to severe. This can cause asymmetries that are difficult to reconstruct. It is possible to repair the deformities left by radiation with multiple techniques--implants, breast lift or reduction, and addition of tissues from another part of the body often the back (latissimus). Even more often, a procedure is required for the normal side in order to lift or reduce that breast to make the two symmetric in volume. These procedures are most often covered by insurance. It is more common, however, to have complications on the radiated side after surgery and this should be discussed with your plastic surgeon. Be sure to speak with a board-certified plastic surgeon and ask questions about the both the cancer and the noncancer breast.

Absolutely! Sometimes at the time of lumpectomy, a plastic surgeon can be there with the breast surgeon to reshape the breast immediately. You may want to coordinate your care with both surgeons if you haven’t had your lumpectomy yet. Even if that wasn’t the case, reconstruction to a breast treated with lumpectomy and radiation is possible later on. Radiation often changes the skin, or the breast is just smaller after lumpectomy. Fat grafting from elsewhere in your body can be a wonderful way to enhance the size of the breast and to reverse the skin changes. In other cases, a small implant may be helpful. Every lumpectomy and radiation situation is unique, but most problems can be improved with reconstruction. Good luck.