Despite the many promising advances in treatments for breast cancer, a breast cancer diagnosis can still feel like an insurmountable challenge for the patient and her family, especially if the doctors indicate that the options for restoring her appearance are limited. In February 2012, a new technique was reported in the Plastic and Reconstructive Surgery journal.  Invented by physicians in Rome, this procedure gives additional options for breast reconstruction to women whose cancer course has made it necessary for them to get radiation treatments.

What Happens to Breast Cells During Radiation?

An important part of most breast cancer treatments is radiation after mastectomy.  The radiation helps to kills any cancerous cells that are in the tissue that the surgeon is not able to remove during the surgery such as lymph nodes. The process helps improve the chances of staving off recurrences of the cancer.

Though radiation is effective at killing cancerous cells, it also can cause problems for the patients who opt to undergo a breast reconstruction surgery after their mastectomies. Because radiation cannot target specific cells, it affects both cancerous and normal cells. 

After undergoing radiation, cells cannot heal as quickly because the blood supply is limited, the cells are at greater risk for infection, and those cells that make up fat, in particular, die.  This fat necrosis is especially detrimental to patients who undergo post-operative breast reconstruction because the implants need a fat base on which to rest. 

How Does the New Technique Help to Enhance the Fat Cells for Reconstruction?

Plastic surgeons have developed a new reconstructive surgery that helps to provide breast implants with a stable fat base.  This reconstructive surgery is phased and will take place approximately 3 to 6 months after the patient completes radiation treatment.

What Happens During the Procedure?

There are a few important steps to this new reconstruction technique. To improve the fat base for the implant, surgeons must perform a fat graft and transplant fat from the patient’s own body into her breast or breasts. 

  • First, the surgeon will use liposuction to gather fat from the patient’s upper legs or stomach. 
  • Second, the surgeon will transplant the fat to the breast and develop a base of fat on the chest cavity. 
  • Third, the surgeon will connect the breast implant to fat tissue and use sutures to close the incision. 

How Long Will It Take To Get the Benefits from This New Procedure?

This reconstruction cannot happen all at once.  To develop an appropriate fat base for the breast implants, the surgeon will perform two or three fat grafts before inserting the silicone gel or saline breast implants.  Additionally, the surgeon will ensure that there is no longer any cellular damage from the radiation before finishing the surgery.   

Who Might Be a Good Candidate for This Reconstructive Surgical Technique?

This surgery has been used as a reconstructive option for patients who have undergone either a mastectomy (single or double) or a lumpectomy (a procedure where as much of the breast as possible is conserved).