Breast reconstruction in the radiated patient is different than in patients who have not received radiation. Patients who have undergone lumpectomy and radiation or patients who have undergone mastectomy and then radiation typically have a tight skin envelope. At times the skin envelope may be amenable to a breast implant reconstruction. Other times, the skin envelope results in a capsular contracture around the mammary prosthesis or the implant becomes repeatedly infected or exposed.
Often in breast cancer surgery, the skin above the lesion needs to be excised for clear margins. Depending upon the location of the skin that is excised, the breast skin may need to be replaced by skin from another part of the body. When skin, fat, and/or muscle is used from one part of the body to reconstruct the breast this is called autologous reconstruction. Autologous reconstruction is also known as flap based breast reconstruction.
The left breast has been lifted to match the right breast. The right breast underwent mastectomy with and abdominal based deep inferior epigastric artery perforator flap reconstruction.