Complication Rates of Radiation on Tissue Expander and Autologous Tissue Breast Reconstruction

Abstract

Total complication rates were similar between tissue expander and autologous reconstructions. Increased major complication rates in patients with tissue expander reconstructions occurred in those with radiation, but was still successful in the majority of patients. Radiation had no influence on autologous tissue reconstruction major complication rates.

Muscle-Sparing TRAM Flap Does Not Protect Breast Reconstruction from Postmastectomy Radiation Damage Compared with the DIEP Flap

“…These surgeons have found the deleterious effects of PMRT to be acceptable and preferable to the delay in reconstruction and additional surgery required for the staged approach. 6,12,[26][27][28][29][30] Others have suggested that breast reconstruction with an MS FTRAM flap rather than a DIEP flap will avoid or decrease the deleterious effects of radiation because MS FTRAM flaps have a more robust blood supply. 31 However, it is not known whether irradiated MS FTRAM flaps experience less fat necrosis and fibrosis than irradiated DIEP flaps.…”

Two-stage implant based breast reconstruction: should we always exchange the tissue expander for an implant right away?

“…Such data confirm previous papers on this topic. In a 2010 study by Berry and colleagues (8), which compares TE/twostage and autologous reconstructions after mastectomy, the major complications rate reaches 45.4% in the IBBR group submitted to RT compared to the autologous one which doesn't show a significant difference in complications with or without RT. Among irradiated patients 70.1% completed their IBBR, while 10.3% were shifted to an autologous flap.…”

Differences in breast aesthetic outcomes due to radiation: A validated, quantitative analysis of expander-implant reconstruction

“…In the small number of studies that have provided information comparing aesthetics in radiated and nonradiated reconstruction patients, most focus on the overall aesthetic appearance of the breast reconstruction and do not provide details regarding specific domains such as breast volume, prosthesis migration and inframammary fold definition (6)(7)(8)(9). We present a quantitative comparison of expander-implant breast reconstruction in radiated and nonradiated patients using a validated scoring scale of breast-specific aesthetic domains.…”

“…Studies have shown that radiation can alter the inherent structure of human tissue and ultimately lead to atrophy or hyperplasia of the epidermis, fibrosis of the dermis, vessel sclerosis and loss of pilosebaceous units (1)(2)(3)(4)(5)(6)(7)(8). The potential ramifications of such findings are of particular concern in the subpopulation of patients undergoing breast reconstruction following mastectomy, in which both reconstructive and aesthetic outcomes may be affected (9,10). While numerous studies have analyzed the impact of radiation on expander-implant breast reconstruction outcomes, a thorough literature review by Kronowitz (11) revealed the relative paucity of focused investigations concerning the influence of radiation on aesthetic outcomes.…”