Is reducing your tissue expander in the breast necessary for radiation?

Question

I had a double mastectomy three weeks ago, and had a consultation with my radiologist. I only had the cancer in one spot in my right breast at the one o'clock position. She is advising me to have the left tissue expander in the left breast taken down before my radiation. Is that really necessary? I'm working full time, and don't want to go six weeks with the right breast full, and the left breast deflated.

Lewis Albert Andres, MD · Answer

Hello!  Thank you for your question!  The radiation oncologists will plan to map their target on your chest wall/axilla when performing the radiation.  It has been requested to deflate the tissue expander, either fully or partially, at some centers, in order to provide an easier target map for the radiation beam.  In my practice and the radiation oncologists that I work with, this is not very common.  Techniques today have allowed adequate mapping with the expander inflated to its maximal volume without any change in effectiveness the the radiation oncologists, especially since the expander is meant to keep that pocket open during treatment in preparation for the exchange for an implant.  Typically, I always do what the radiation oncologists finds to be the best method in his/her hands as the radiation, if needed, will be an important adjunct to your treatment to decrease the recurrence rate of cancer.  If deflation is requested, it will be important to reinflate the expander to its pre-radiation volume immediately after completion of your therapy.  Best wishes!

Allen Gabriel, MD, FACS · Answer

Radiation oncologists will need to target the location of
the cancer for radiation.During
simulation (location of the treatment is mapped), the radiation oncologist can
request both expanders, or just one expander to be deflated.We work around their request to make sure
that we provide the optimal treatment area.I hope this helps.Best of Luck
with radiation therapy.

Craig W. Colville, MD, FACS · Answer

Usually, they don't reduce the tissue expander all of the way, only a small amount. We have done this before and the amount we take out of the tissue expander is, most of the time, not even noticeable. However, this is a case by case determination and you should ask your doctor how much she intends for them to "take down" on the left tissue expander. Chances are it's just a miscommunication and the amount to be removed will not leave you with one full breast and one deflated breast, but like I said earlier it is case by case. Best to double check and make sure all the facts are straight so you know what you are getting into. Good luck!

John J. Edney, MD · Answer

When tissue expanders are present prior to radiation therapy it is sometimes necessary to change the volume of one or both expanders in order to deliver optimal radiation.  This is a recommendation that would be made by the radiatin ononcologist. It is not always necessary.

Khashayar Mohebali, MD, FACS · Answer

Unfortunately it is a rather common practice among radiation oncologist to ask for partial deflation of your tissue expanders prior to therapy.  It is usually not fully deflated but enough to loosen the skin.  Best of luck completing your treatement.

Is reducing your tissue expander in the breast necessary for radiation?

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Answer: Reducing tissue expander volume before radiation

Answer: Reducing tissue expander volume before radiation

Answer: Expander deflation

Answer: Expander deflation

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Is reducing your tissue expander in the breast necessary for radiation?

Answers (6)

Answer: Reducing tissue expander volume before radiation

Answer: Reducing tissue expander volume before radiation

Answer: Expander deflation

Answer: Expander deflation

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Recommended reading

Everything you need to know about Breast Reconstruction

Our mission is to create a world where every investment in modern beauty is Worth It.