Bilateral mastectomy with reconstruction (implants) and radiation.

I have tried to use a band to encourage the radiated implant to go lower but it seems like the lower portion of the breast has no give and it actually puckers at the suture line which is lateral from nipple to armpit. My surgeons has lowered and enlarged pocket twice. Do you think that I will have to have skin/tissue grafting to the lower portion of my breast to correct this issue.

Doctor Answers 2

Asymmetry of reconstructed breasts is common after radiation.

You describe a very common and predictable outcome of bilateral breast reconstruction (by any method), followed by radiation to one of the two reconstructed breasts.  The radiated breast is most likely to gradually continue to contract, and become more firm and higher on your chest, with less natural ptosis (sag).  The best way to improve the symmetry is to add non-radiated skin and fat, in the form of a flap, from your belly or back, to the lower part of the radiated breast, or the replace the implant entirely with a flap of non-radiated tissue.

Houston Plastic Surgeon

Breast reconstruction after radiation

Thank you for your question. Unfortunately, radiation can result in significantly increased contracture and firmness in implant reconstruction. Although using a strap and scar massage can sometimes improve the firmness, many times reconstruction with autologous tissue, such as an abdominal flap or a latissimus flap with underlying implant is necessary to achieve the best results. I would discuss this with your plastic surgeon, and if he/she does not perform autologous reconstruction, seek another opinion so that you can consider all of your options. Best regards

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