Patient 6 Gallery

Before and after breast reconstruction in a 41 year old woman with breast cancer.  She had a left sided tumor that was amenable to lumpectomy and radiation.  She wished to undergo immediate breast reconstruction - meaning having the lumpectomy and reconstruction at the same procedure.

A combined Breast Surgery and Plastic Surgery procedure was scheduled.  In general, the Plastic Surgeon makes the initial markings, and is present for the lumpectomy portion of the procedure.  The remaining breast tissue is then rearranged as a breast reduction and lift.  A balancing breast reduction is done at the same surgery.

Radiation generally follows 6 weeks after this surgery.  We expect that radiation will cause the breast to shrink slightly - therefore, the breast is made slightly larger than the other (non-radiated) breast to allow for symmetry.

She underwent a special type of radiation therapy involving beads inserted into her breast called "brachytherapy".  After any type of radiation, the breast will shrink anywhere from 5% to 20%.  This results in the radiated nipple and areola sitting a little higher than the non-radiated side, and a slightly contracted breast envelope.

I usually describe the effects of radiation as being "like putting a wet wool sock in the dryer on high heat - even if it's only for 5 minutes, it will shrink a little".  The shrinkage occurs over a year after radiation is complete.  If radiation has just been completed or is currently underway and a patient is interested in breast reconstruction, I recommend waiting at least 6 months after radiation is complete before reconstruction is planned.

Follow up photos are shown one year after surgery for this patient.  Her scars are continuing to mature and will continue to fade and be less red with time.  Interestingly, radiated scars are actually nicer than non-radiated scars!  It promotes less redness to scars and a flatter final scar.  Did you know - radiation is a proven treatment for keloid scars?