Radiation Therapy Effects

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If you had radiation therapy after a breast reconstruction surgery, it may have caused changes to your reconstructed breast. Radiation therapy can raise your risk of developing complications such as capsular contracture, thinning of the skin, and extrusion of an implant.

Breast asymmetry

It’s common for a reconstructed breast to become firmer and to sit higher on the chest after radiation. Those particular changes happen because the radiation therapy caused shrinking of the skin (if you have a tissue flap or an implant) and/or capsular contracture (if you have an implant).

The breast that was treated with radiation may look significantly different from the breast that did not receive radiation. In that situation, your plastic surgeon may recommend that you have a procedure on the non-radiated breast, such as a breast lift, so that it better matches the radiated breast. (For more about correcting imbalance, see our page on Asymmetry). If you developed capsular contracture in the breast that received radiation, your plastic surgeon may or may not recommend treating it, depending on whether it’s causing you discomfort and distorting the shape of the breast.

Skin and tissue imperfections

Radiation can also cause the skin over an implant or tissue flap to become tighter, tougher, and more rigid. In some cases, a treatment called fat grafting (or “fat injection”) can help soften and improve the skin and/or thicken the layer of tissue between an implant and the skin.

During a fat grafting procedure, fat tissue is removed from another part of your body — usually your thighs, belly, or buttocks — by liposuction. The tissue is then processed into liquid and injected into the breast area. The fat that survives establishes a blood supply within a few days. In some cases, very little of the fat survives. In the best case scenario, about half of the fat that is injected will stay there permanently, while the rest will be reabsorbed by the body. Several sessions of fat grafting may be needed to get the best results.

If you’re considering fat grafting, talk with your plastic surgeon about whether your results are likely to match your expectations. Even though fat grafting is used to improve skin and tissue imperfections after radiation therapy, fat grafting doesn’t “take” as well in radiated tissue as it does in non-radiated tissue. It’s also important to know that once you take fat from a donor site on the body – such as the belly – to use for fat grafting, then you won’t be able to use tissue/fat from that site again for breast reconstruction. If you decide you want a flap reconstruction in the future, you may have already used up a key tissue source.

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