This week ,Richard M. Kline, Jr., MD , of The Center for Natural Breast Reconstruction answers your question.
Question: What are reconstruction options for me as an overweight person who had radiation?
Answer: Thanks for your question. Knowing only that you are overweight and have had radiation, I can only speak in generalities, but it may be of some interest to you.
Radiated patients are far less likely to tolerate implants than non-radiated patients, so that may mean that you could be better served by natural breast reconstruction with your own tissue. While it can be extraordinarily difficult (sometimes impossible, actually) to achieve a satisfactory delayed reconstruction with implants in a radiated patient, radiation commonly has almost no impact on our ability to reconstruct you with your own tissue, since we are bringing fresh non-radiated tissue to the area.
Additionally, implants are only commonly manufactured up to a volume of 800 cc. While this may seem like a lot (and actually is a lot, when used for cosmetic augmentation), it often falls far short of the volume requirements needed by a large patient for a complete reconstruction. Fortunately, there is no firm limit on how large a natural tissue flap can be transferred, except for how much tissue is available. We have in the past transferred flaps in the (1500 – 2000) cc range with success.
Of course, extra weight (also depending to some extent on how it is distributed) can bring additional risks. Extra weight brings an increased risk of blood clots (which can be fatal), and an increased risk of wound healing problems. As a very rough guideline, and, again, with the knowledge that how the fat is distributed makes some difference, we start to get concerned when the BMI exceeds 30 and approaches 35. This doesn’t necessarily mean that surgery can’t be done, just that all of an individual’s specific risk factors and options must be scrutinized very closely before making specific recommendations.
I hope this has been of some help. Please feel free to call or email if you would like more information.