This week, James E. Craigie, MD, of The Center for Natural Breast Reconstruction answers your question.

Question:  I had a double mastectomy May 24, 2016. My treatment was 5 rounds of chemo and I have completed 9 of 30 radiation treatments. My radiation oncologist had told me that reconstruction can’t be done until 1 year post radiation. I was to start reconstruction at the time of mastectomy but due to 1 positive node that was not done. That was devastating to wake up to that news. I wanted to know if that is true since I have read that a lot of women get expanders and then have radiation. I want reconstructed as soon as it is possible. Any information would be appreciated.

Answer:  I’m sorry things have thus far not worked out ideally, but there is still an excellent chance you can have a satisfactory reconstruction.

Expanders are often put in at the time of mastectomy, whether or not radiation is anticipated, with the goal being to complete expansion before the initiation of radiation. After you are radiated, expansion becomes much more difficult, so much so that many surgeons (including us) will not even attempt it.

The good news is, radiation does not in any way impact our ability to do reconstruction with your own tissue (typically with DIEP flaps, sometimes with sGAP or other flaps). While most surgeons wait for 6 months after the completion of radiation to do flap reconstruction, it can sometime be done successfully as early as one month, depending on how healing is progressing.

I would be happy to call and discuss your situation in more detail if you wish, and thank you very much for your question.

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