After DIEP flap, if radiation is required, how long will radiation be delayed?

Question

Is it 4-6 months as it is for women who have radiation prior to DIEP flap?

Daniel Butz, MD · Answer

Our main goal is that you are completely healed prior to starting radiation. That normally takes 4-6 weeks but if there any issues this may be delayed until they have resolved. 
There will likely be some skin changes and volume loss as the result of the radiation.

Ryan Rebowe, MD · Answer

Your radiation will need to be delayed at least 6 weeks to ensure proper wound healing. If radiation is required following mastectomy, it is typically not safe to wait 4-6 months following surgery as the goal is to prevent further spread of cancer. It is necessary, however, to wait long enough for the majority of healing to occur, which will take about six weeks.

Derek Fletcher, MD · Answer

On average, it takes 6-12 months for adult skin and soft tissue to recover from radiation enough to tolerate DIEP surgery. Some patients recover faster some slower. I schedule follow up with my patients 6 months after the last dose of radiation to assess skin recovery and determine timing of breast reconstruction.

Christine Fisher, MD, FACS · Answer

I appreciate your question. In cases in which we know radiation is planned, I recommend patients wait to perform the DIEP flap until after radiation, since the treatment can cause some changes to the newly constructed breast. If you have the DIEP flap procedure and then find out radiation is needed, it usually takes about four to six weeks for the body to heal sufficiently for radiation treatment to begin. When you select your board-certified plastic surgeon for your reconstruction, it is important that the two physicians work as closely as possible to ensure your treatment and reconstruction surgery are as safe and seamless as possible. Choosing a plastic surgeon that specializes in breast reconstruction will also enable your team to produce the best outcome for you. Best wishes on a successful process!

Nima Naghshineh, MD, MSc, FACS · Answer

Thank you for your question.
Radiation in association with flap or microsurgery reconstruction can be performed before or after.In the setting when it is performed after the reconstruction, you can expect to have some volume loss of the breast as well as potential changes in the quality and color of the skin. This does not happen in all patients, but it is possible.
Typically radiation treatments start around 4 to 6 weeks after surgery, however, it is important to coordinate with the oncologist as well as the radiation oncologist regarding the timing of the treatments. 
Any changes to that breast associated with the radiation can be addressed in the future using various techniques such as Renuva, fat grafting and revision surgeries.
Hope this helps and good luck!

Neil Tanna, MD, FACS · Answer

Radiation after DIEP flap is often started 4-6 weeks after surgery. This gives ample time for the surgical site to heal.

David Light, MD · Answer

Thank you for your question.  Radiation usually begins 4-6 weeks after surgery if all goes well with your healing.  If there are any issues with healing then radiation may be delayed until your surgeon is comfortable that your incisions are healed well enough to begin radiation.

If you require an revisions following your radiation (ex: fat grafting, scar revisions, nipple reconstruction), then that procedure will likely be delayed 4-6 months until your skin has recovered from radiation.

I hope this helps.  Good luck.

Regards,
David Light, MD, FACS

Ali Sadeghi, MD, FACS · Answer

Thank you for your question.  Typically DIEP reconstruction should be delayed until the radiation therapy is completed. Irradiation of the flap causes volume loss, fat necrosis, hardening of the flap and color changes on the skin paddle of the flap.  In the instance that irradiation is needed after a DIEP flap has been performed, it can be started 4-6 weeks after the surgery.  I hope this helps.

After DIEP flap, if radiation is required, how long will radiation be delayed?

Answers (8)

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