2 Years Ago I Had Radiation on Left Breast After Cancer Surgery.

There are no changes for my breast after radiation.Now I WANT mastectomy and reconstruction,but ONLY with tissue expander. CAN I have that ? I DO NOT want to have FLAP. Last 6 years I have implants after breast augmentation.

Doctor Answers 8

Implant reconstruction after radiation.

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It is certainly possible to attempt an implant reconstruction after radiation, but the chances of significant complications and failure of the reconstruction are high. This is because radiation affects of the cells and tissues in its path, even if you do not see or feel the changes yourself. In particular, capsular contracture is known to occur at a very high rate after implant reconstruction with radiation.

Because of the potential complications associated with implants, breast reconstruction using natural tissue is generally considered the best method for women who will require or have already had radiation.

Breast implants after radiation

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It is certainly possible to have a tissue expander reconstruciton after RT therapy but the risks are definitely higher.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Mastectomy and Tissue Expander Recon

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It is certainly a viable choice and I have done this before.  You need a skilled breast/general surgeon to perform a nice mastectomy and then alloderm and tissue expander reconstruction.

Radiation to the breast does increase the complication rate for expander reconstruction, but if you have a fair amount of skin and have an appropriately done mastectomy, an expander reconstruction is a viable option.

Good luck.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 88 reviews

Tissue Expander Is Possible After Localized Radiation

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It is possible to have a breast reconstruction with a tissue expander/implant after localized radiation.  If you have a lumpectomy and radiation, then this is a very controlled, localized form of radiation.  It should not impede your ability to have the tissues expanded with the expanders, as long as your surgeon is cogniscent of the fact that there was some radiation done in the area before.

2 years ago I had radiation on left breast after cancer surgery

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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!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 28 reviews

Radiation on left breast

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Yes an expender reconstruction can be accomplished but it has much higher risks. These risks can be discussed with your chosen plastic surgeon. Best of luck from MIAMI Dr. B

Expander/Implant Reconstruction Post Radiation

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It is possible to consider Implant Reconstruction after radiation.  However, you may be at increased risk of capsular contracture (scar tissue formation around your implant - where your breast could become hard or raised or painful)  and for slow healing.   Your plastic surgeon will need to assess the tissue quality and your anatomy to finalize your reconstructive plan.   It is my preference, however, to consider some form of autologous (using your own tissue) reconstruction after radiation.  I realize this may not be the answer you are seeking.  The reason is that autologous reconstruction (tissue or flap reconstruction) can potentially bring new tissue, new blood supply, and perhaps new healing potential  to a radiated chest wall.   My hope would be to minimize the risk of implant related complications for my patient down the road.   I suggest you meet with a plastic surgeon who is a member of the American Society of Plastic Surgeons and certified by the American Board of Plastic Surgery to review all your options.

Post-radiation breast reconstruction

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While radiation to the breast tissue increases the risks and complication of implant, it does not preclude the use of expanders and implants. Depending on your specific anatomy, you may not have to undergo an expander stage as sometimes serial implants are more reasonable. Be sure you consult with a plastic surgeon even before your see a general surgeon since the plastic surgeon is the best specialist to determine the route to an aesthetic end result.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

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.