I had left breast Mx on 3/ 2011, followd by 33 trtmts of radiation; total of 60.4 Gy over 33 fractions,ended 6/ 2011. Reconstruction on 4/ 2012 as follows; Right skin sparing mx followed by LD Flap on both sides; silicone implant placed on right; T.E. and back skin (to help stretch radiated skin) placed on left side. Follow up apts.to insert 60cc to T.E. bi-wkly.. Now, PS is planning to replace T.E with silicone implant. Am I at a high risk for capsular contracture, healing, or ? PLEASE ADVISE!
Lattisimus Dorsi Flap With Silicone Implant Reconstruction After Radiation? (photo)
Doctor Answers 2
Reconstruction After Radiation
These are very challenging cases for us all. Overall you seem to have a great reconstruction going. Remember that it is nearly impossible to make both breasts look the same. Especially since you have had radiation on the left. Even with a Lattisimus flap on the left you will always have a more contracted looking breast on the radiated side. Sometimes with other flaps like a TRAM flap you can get a little more natural droop on the radiated side, but it is TOUGH at best. Every single patient in this world with implants have risk of contracture so you are not an exception. The radiated side is usually more at risk. You look like you could use a little tightening of the right breast but that really is hard for me to know without examining you. Radiated breasts always have a chance of poorer healing but that is why you had the muscle flap done. It should help you heal. Your surgeon seems to be doing a great job.
Capsular contracture and radiation
Radiation does pose a great risk of increased capsular contracture rates. Bringing healthy tissue into the field helps minimize that risk but it is still present.