Surgery on radiated breast - will a lift on one side cause asymmetry? (Photo)

Question

I had a lumpectomy and radiation ten years ago and I'm finally ready to fix the defect left from the lumpectomy. Dent on outside of breast and retracted nipple. My consultations have both suggested I do nothing to the radiated breast because it's hard to predict the outcome because of the radiated skin. Both suggested a lift on the non-radiated breast. My breasts are nearly the same size but I worry a lift on one side will make that breast smaller. Plus it will look better but I'll still have the defect on the radiated breast. They are even suggesting fat transfer isn't a good option. Should I keep looking for consults or am I stuck with my post-cancer breast the way it is?

Daniel Barrett, MD · Answer

Dear Original327208,

it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Donovan Rosas, MD · Answer

Radiation therapy, while essential to cancer care can be detrimental and limiting to reconstructive options.

Radiation compromised tissue does not heal or expand in a predictable way. Thus patients need to temper expectations for outcomes post therapy. Often times, surgeons are limited to addressing the contralateral untreated breast (reduction/augmentation/mastopexy).

Addressing the radiated breast carries significant risks (healing difficulties/infection). Thus, fat grafting often plays an outsized role.

Ultimately, managing expectations is crucial.

With regards to your specific question, contralateral lift is preferred. The amount of resected tissue can be minimized. The radiated breast is best addressed via fat grafting (serially). Studies have shown that fat grafting can be an affective means to mitigating radiation induced outcomes on the chest wall.

As always, discuss your concerns with a board certified plastic surgeon (ABPS),

Surgery on radiated breast - will a lift on one side cause asymmetry? (Photo)

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