Radiation after alloderm?

I recently had bilateral mastectomy with reconstruction with alloderm and silicone implants. Now I will be starting radiation. Will the radiation cause damage to alloderm?

Doctor Answers 11


Radiation is harmful to all the tissues in the area and will increase your risk for capsular contracture and implant malposition (making the implant ride high).  That being said right now we think that alloderm has a protective affect on capsular contracture in the radiated setting.  If I am doing an expander reconstruction on someone who is going to get radiation, I would use alloderm rather than avoid it. 

Dayton Plastic Surgeon
5.0 out of 5 stars 3 reviews

Alloderm and Implant Breast Reconstruction with Radiation

Radiation can affect implant breast reconstructions by causing fibrosis of the tissues.  In some cases Alloderm can offer a protective effect to the area.  Overall, implant breast reconstructions can have issues whether Alloderm was used or not, such as pain, capsule or scar contracture, thinning of the overlying skin and soft tissues, or even wounds.  Some studies have shown the risk for implant loss to be as high as 35-40%, in which case additional procedures may be required to correct, such as autologous flaps (diep flap, latissimus flap, etc).

Many women have excellent results with implants and Alloderm after radiation, and any issues that may arise are certainly a case by case situation depending on the patient tissues, the radiation dose, and the effect seen on the patient's tissues.

Kent (Kye) Higdon, MD
Nashville Plastic Surgeon
5.0 out of 5 stars 2 reviews


Radiation always increases the risk of capsular contracture following mastectomy and implant reconstruction.  Alloderm can offer some protective benefit depending on how much was used to cover the implant and whether your implant was placed above or below the muscle.

I hope this was helpful.  

Peter Hyans, MD
Summit Plastic Surgeon
5.0 out of 5 stars 26 reviews

Radiation and alloderm in breast reconstruction

This a complicated question with no easy answer because there are many variables.  The thickness of the skin and fat that remain over the alloderm sling a keys.  If this tissue is extremely thin then with then there can be issues.  Capsular contracture is always a concern but hopefully not as much with the alloderm in place.

Radiation, Reconstruction and Capsular Contracture

Radiation causes tightening to any tissue in the treated field. Typically this can result in skin tightening as well as contraction of the capsule which forms around the implant after healing of the reconstruction.

ADM's (Acellular Dermal Matrices) such as Alloderm have been shown to be protective in the setting of radiation. Studies have demonstrated a mitigation of some of the unintended effects of radiation therapy.The Alloderm will not be in particular affected, and may in fact provide some measure of protection. There will alwyas be some degree of tightening, however, the shift to the use of ADM has turned what have in the past been certain severe contractures into mild (or non-existent) contracture.

As always, discuss your concerns with a board certified plastic surgeon.

Donovan Rosas, MD
Kissimmee Plastic Surgeon
5.0 out of 5 stars 9 reviews


Time will tell if you will develop issues with the radiation and your implant based breast reconstruction. I recommend you are complaint following up with your plastic surgeon as you may experience changes on your breast soft tissues.

Carlos Medina, MD
Miami Plastic Surgeon
3.7 out of 5 stars 11 reviews

Radiation changes with alloderm

Thank you for your question. Radiation will change all tissues in its path and it varies widely among patients. Most experience skin tightening and fibrosis as well as decreased shoulder range of motion. The implant may displace upward as the envelop tightens up. At this point the alloderm has likely incorporated into the tissue and should respond in the same way. Your plastic surgeon will advise you on things you can do to limit the effects such as massage and shoulder exercises. Good luck!

Emily Hartmann, MD
Chico Plastic Surgeon
4.7 out of 5 stars 14 reviews

Radiation after reconstruction

it's rare that tightening is not an issue after radiation, regardless of the presence of alloderm.  alloderm has been used successfully for the treatment of capsular contracture following cosmetic breast augmentation but has less utility for this problem in the face of radiation.  your plastic surgeon will follow along with you but you can expect additional procedures such as fat grafting+/- a flap procedure (bringing non-radiated tissue in) to cover or replace the implant

Ashish K. Jain, MD
Columbus Plastic Surgeon
5.0 out of 5 stars 5 reviews

Radiation effect

Radiation will cause swelling and tightening of all breast tissues from skin to capsule. Some report that there is less contracture in the area of the Alloderm but that is not alwyas the case. I have seen patients do very well and have minimal tightness and others developed significant tightness. I do believe massage and increase range of motion exercises throughout the process will help you. I encourage you to continue exercising your shoulder and massaging with the cream provided. 

I encourage you to stay positive  and healthy  and you will do great.

Helena Guarda, MD
Suffolk Plastic Surgeon
5.0 out of 5 stars 2 reviews

Radiation almost always affects the result of breast reconstruction

Radiation causes scarring and tightening of tissues.  It can affect your shoulder mobility due to tightening of the pectoralis major muscle, so it's important for you to have full range of motion going into radiation, and to maintain it during radiation.  If your body has incorporated the Alloderm (as it should have by now) then the radiation shouldn't affect it any more than it affects the surrounding tissues.  There is some evidence that Alloderm prevents or lessens capsular contracture, which almost always occurs with radiation.  The scar that your body makes around the implant (the capsule) will tighten with radiation.  It's possible that the Alloderm will lessen this, but in my opinion radiation will always have some effect.  The results are typically acceptable, but sometimes patients benefit from conversion to a flap reconstruction. 

Eric G. Halvorson, MD
Asheville Plastic Surgeon
5.0 out of 5 stars 3 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.