My right breast is alot smaller then the left, do to lumpectomy removal and radiation! Can this be fixed?

Thank you for your question.
Without photos or insight into your oncologic treatment, this is difficult to speak on. Generally speaking, a radiated breast needs at least six months to heal before any surgery to decrease risk of wound healing. I recommend speaking to your plastic surgeon to discuss your options moving forward.

Hello! Thank you for your question! Contour deformities or asymmetry between size/shape of the other breast following lumpectomy and radiation may occur after everything settles and is not an uncommon scenario following lumpectomy.  There are several options to ameliorate this and you should discuss your options with your plastic surgeon to determine which option would be best for you. It is recommended to wait approximately 6 months to one year after your radiation therapy is completed before considering any reconstructive procedure on the breast.Typically, implants in the setting of an irradiated breast has higher rates of complication, including infection, wound complications, capsular contracture, etc. Many surgeons, including myself, have placed implants to improve symmetry in these instances with excellent results. However, if your deformity is a contour issue with a soft tissue deficiency, placing an implant beneath the breast may actually worsen the deformity as it is not addressing the issue to "fill" the defect. For such problems, it may be a wiser decision to consider fat grafting for smaller defects, where fat is harvested for another area of your body and then reinjected into the defect, thus adding volume as well as having the added properties of fat graft stem cells. Autologous flaps such as local tissue, TAP, or LDMF may be needed for larger soft tissue defects.  Of course, reduction of the other breast to create symmetry is an option, or a combination of procedures on both breasts. Best wishes!  

There are many ways to improve a difference between breasts after lumpectomy. Fat grafting, implant placement, or addition of autologous grafts are ways of making the smaller side larger to match. Another choice would be to decrease that larger breast to match the smaller one. The different choices depend on how you look now, what the pros and cons of the various options are for you specifically, and what your appearance goals are. Good luck!! 

Asymmetry following lumpectomy and radiation is not uncommon.  The lumpectomy removes breast volume, and the radiation causes changes in the breast tissue and overlying skin.  The radiated breast typically appears smaller and higher on the chest wall while the non-radiated breast appears larger and remains in its native lower position.  There a few breast reconstruction options that can address your problem and may require a combination of techniques.  The volume of the radiated breast can be enhanced with either a flap (healthy tissue from elsewhere in the body taken along with its blood supply) or with fat grafting obtained via liposuction.  Transferred fat is believed to contain stem cells that also rejuvenates the hard, radiated skin, while a flap replaces the radiated skin with healthy skin from elsewhere in the body.  The non-radiated breast can also be reduced in size or lifted with a mastopexy to match the appearance of the radiated/reconstructed breast.  I would recommend consulting with a plastic surgeon familiar with the various breast reconstruction options who can tailor your reconstruction to your specific needs.
Ziyad Hammoudeh, MD

Each time I have a patient referred to me for this problem we start with a review of the history and any associated problems after surgery or radiation treatment.  On exam I am looking for changes in the the nipple position based on where the lumpectomy was performed and the overall change in size secondary to radiation treatment.  Exam of the normal breast is used to then help decide options.  In some cases a lift or reduction on the normal side restores balance.  In other instances I have performed breast augmentation with different sized implants to provide balance again.  In this setting I use the photos of the patient and a 3D imaging program to help give the patient and idea of the appearance with different sized implants in an effort to provide balance again.

Thanks so much for your question. It happens fairly often and it is usually a very easy thing to fix.  You will either need to add volume to the smaller side or reduce the larger side. Often we will do a combination of both. It really depends in your goals. Your surgeon will listen to your concerns and goals about size, then devise a plan specific to you so that you can regain symmetry in the manner that is best for you and your body. 

Your situation is not an uncommon one after lumpectomy and radiation.  Your right breast will likely need some autologous tissue moved in the the form of a flap or fat grafting.  Your left breast may need a lift as well to best match.  Because situations like yours are complex, the final plan can only be made after a formal consultation.  

Depending upon the difference between the two, the radiation injury, available donor sites, will determine what can be offered to you. You need to be seen in person.

Breast reconstruction in the radiated breast can be very difficult at best. There are options for patients in your situation. It may involve reducing the non radiated breast to match the radiated breast. You may be a candidate for fat transfer to the radiated breast as well. Generally I try not to make any incisions more than necessary in a radiated breast because wound healing is so poor. Being that said to inject fat back into the breast only requires a small stab incision large enough to accommodate the cannula to inject the fat and generally heal very well. You would need to be seen in person to really discuss more options. These are just a few of the things you may be a candidate for.

Breast reconstruction after lumpectomy and radiation therapy is much more complex. You need  in person examination. Discussion of surgery  and discussion of all your options, magnitude of the surgery and recovery. Then you can make your decision with your plastic surgeon.