Breast reconstruction is a unique procedure customized to each patient and her circumstances. If you know that you will require radiation after your mastectomy, discuss your reconstructive options with our double-board-certified plastic surgeon, Dr. Jay Orringer.
Post-mastectomy radiation treatment makes reconstruction with breast implants challenging and often less satisfactory. Implants in the setting of radiation are prone to capsular contracture (scar tissue that tightens around the implant that may cause pain and deformity), infection, and extrusion (implant loss).
A 2020 study published in the Journal of Clinical Oncology evaluated the integration of breast reconstruction and postmastectomy radiotherapy. Researchers found that patients who had implant reconstruction after receiving radiation therapy were less satisfied with their results than women with implants and no radiation therapy. However, women with autologous reconstruction (reconstruction using one’s own tissue), with and without radiation, experienced similar satisfaction rates.
Consequently, autologous tissue flap surgery is often the preferred reconstruction method in the setting of radiation because it usually avoids implants. If radiation therapy is anticipated, a tissue expander will often be placed at the time of the skin-sparing or nipple-sparing mastectomy. After initial healing from radiation, the expander may be replaced with a DIEP flap from the abdominal wall or an SGAP flap from the upper buttock.