I Have a Breast Encapsulated, Occurred After a Lumpectomy, then Extensive Radiation. What is the Best Way to Correct This?

Doctor Answers 5

Capsular Contracture after Lumpectomy and Radiation Therapy

Unfortunately, breast deformity is a common occurrence after a lumpectomy followed by radiation therapy. It is best to wait 6 months or longer before pursuing reconstructive surgery, as this will allow for the inflammation from the radiation injury to resolve. When considering surgery, there are Multiple Treatment Options depending on the severity of the deformity. I recommend finding an experienced board certified Plastic and Reconstructive Surgeon in your area who can perform a thorough examination of your breast, and come up with the best solution that the would optimally restore a more natural appearing shape.

Thank you for your question and best of luck.

 

Gregory C. Park, M.D.


San Diego Plastic Surgeon
5.0 out of 5 stars 158 reviews

Breast capsular contracture following lumpectomy and radiation treatment

I am sorry to hear that you required a lumpectomy and radiation.  Although this is a good option to treat localized breast cancer while sparing the breast from a mastectomy,  the radiation can cause both the breast tissue and the capsule around a breast implant to shrink.  Shrinking of the breast capsule leaves less space for the implant and can make the breast feel hard and cause the implant to shift out of its proper position.  If you have just had the radiation treatment, I would suggest waiting at least 6 months before considering any surgery.  As the effects of the radiation on the breast subsides the contracture may improve.  If it doesn't, there are several options including opening or releasing the contracture (capsulotomy) or removing it (capsulectomy).  To help prevent a recurrence of the contracture your surgeon may suggest the use of an acellular dermal matrix graft or ADM (a skin graft in which the cellular component has been removed).  The ADM can be used as a deep covering over the implant to help limit a contracture recurrence.  Best wishes.   

Vincent D. Lepore, MD
San Jose Plastic Surgeon
4.9 out of 5 stars 50 reviews

Capsular contracture following lumpectomy and radiation.

Unfortunately, capsular contracture of breast implants following radiation is a common occurrence. This can occur even if the implants have been soft for years prior to the radiation. In some circumstances, the capsule is not contracted, but because of the tightening of the breast following radiation, it gives the same impression. Recommendation is conservative therapy first - moisturize the skin and perform massage several times a day. This may take more than a year before you notice improvement in the feel of the breast. If the contracture persists, removal of the capsule and replacement of the implant with an acellular dermal matrix is a good option. The dermal matrix lowers the likelihood of recurrence of the capsular contracture significantly. However, you would need to check with your particular insurance provider to see if this type of correction is covered under their breast coverage policy.

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 19 reviews

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Capsule post radiation

This is not uncommon.I thiknk the best thing to do would be massage and time to see if this will soften.soemtimes you may need a capsulectomy and implant exchange.

Robert Brueck, MD
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Implant encapsulated after radiation

When a breast is irradiated for treatment of breast cancer, often with an implant reconstruction a capsule develops. Sometimes a salvage procedure can solve the problem. This can be with a latissimus and implant, or autologous tissue like a TRAM, free TRAM, or DIEP, or other perforator flap.

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