Scar revision to radiated skin post chest wall resection? (Photo)

Question

I've had a bilat mastectomy in 2001, and radiation in 2005. In 2012, I had a chest wall resection with a metal mesh piece placed over the rib area, but the scar healed horribly. The tissue is firmly adhered to my chest wall in a bunched up way. I saw a reconstructive surgeon for a scar revision, but he advised it could just do the same thing again. Are there any new or innovative techniques to resolve this type of tissue adhesion problem? The tissue is too stuck to massage.

Victoria Aimé, MD · Answer

I would recommend considering fat grafting to the area of the radiation and the scar. Harvested fat contains stem cells and can improve radiated tissue quality. You appear to be quite slim in your photo, but you would not need much fat to transfer to achieve your goal and most patients have some areas where fat can be harvested (i.e. flanks, inner thighs, lower abdomen). Typically it requires more than one fat grafting procedure and some time to see the improvement in skin and scar quality. It can be done under local anesthesia so long as it is done as a sterile procedure (given that you have metal mesh in place). Hope that helps! Wish you all the best!

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