Can I Have A Breast Lift If My Breasts Have Had Radiation?
Q: Dr. Eppley, I had a consultation with a plastic surgeon last year who had all my personal information prior to the visit. Within two minutes they told me they don’t do any surgeries of any kind on cancer patients who had received radiation. I was upset, mad and disappointed because they knew all my history. Then I was charged $125.00 to be told that. Are plastic surgeons not doing surgeries on cancer patients? I do not need reconstructive work. I only had a lumpectomy but I would like smaller breasts and a lift. Any information would be greatly appreciated.
A: Reconstructive and cosmetic surgery can be done on the irradiated breast but it requires different considerations and surgical approaches. The irradiated breast, which may appear quite normal, is not. Its ability to heal is compromised by the negative effects of radiation on the blood vessels that supply the breast tissue, skin and nipple-areolar complex. A surgical procedure will likely unmask its limited healing ability resulting in incision separation, skin necrosis and partial or complete loss of the nipple.
In reconstruction of the irradiated breast, this well known compromised blood supply is managed by bringing in normal tissue that has a good blood supply through tissue flaps such as the LD, TRAM and DIEP. Such drastic’measures in cosmetic breast surgery, however, are obviously not warranted.
The choice in the irradiated breast patient that wants to undergo a cosmetic procedure like a breast lift is to either take the risk that no such complications will occur or to improve its healing capabilities. Improving the blood supply of the irradiated breast is done by initially doing first stage fat injection therapy. Through liposuction harvest, fat is concentrated and injected through the breasts implanting fat and stem cells. This approach has been well shown to obviate many of the negative effects on the tissues caused by radiation. Three months after the injection therapy, a breast lift/reduction can be more safely done. It may seem counterintuitive to initially make the breasts a little bigger by fat injections but this therapy completely changes the vascularity of the tissues which is essential to heal from any tissue injury.
Dr. Barry Eppley