Healing Radiated and Scarred Breasts – from Styrofoam to Butter

Providing the Best in Natural Breast Reconstruction to Orlando & nearby areas of Florida

Wed, 08/28/2013

Breast Cancer strikes one in eight women, and once stricken, with the help of their doctors, women have to decide the beast treatment option for them. The two most common options for breast cancer treatment for women today are mastectomy (sometimes with additional radiation), or partial mastectomy (lumpectomy), followed by radiation. Chemotherapy may also be part of the recommended treatment options.

Fat grafting or autologous fat transfer (AFT), is emerging as an option, and in many respects a better option, for breast reconstruction after cancer treatment. Breast Reconstruction with AFT has many advantages over other available options such as implants, expanders and tissue flaps. Without question, in the face of radiation, AFT is often the best and sometimes the only available option for reconstruction.

When I consult with women seeking breast reconstruction after cancer treatment, particularly those who have been treated with radiation, it is important to explain the fat transfer process. Fat transfer for most breast reconstruction, is a process of incrementally injecting fat every 2-3 months to the breast area to progressively build a breast.

Unfortunately in women who have had radiation there may be severe scarring. Severe scarring may also be seen in women who have experienced complications with other reconstruction methods. The challenge then is to convert this scarred tissue to healthy soft tissue.

The analogy that I use is that we have to convert scarred tissue that has the consistency of Styrofoam, to healthy soft tissue with the consistency that is more like butter. If one tries to inject butter (fat) into Styrofoam (scar) we will fail, and any fat that we do inject will probably not survive. So the process has to involve a technique known as Rigottomies or needle scar release. This is a procedure where we use small needles to release the scar or Styrofoam, to create small spaces into which we can inject small droplets of fat (butter). We then repeat the process to again create more spaces in the Styrofoam to inject more droplets of butter, and in time, we completely replace the ‘styrofoam’ with ‘butter’ and we transform hard dense and contracted scar tissue, to soft, natural feeling and full fatty tissue that feels the way a normal breast feels. This process must be done gradually, as only a limited amount of fat can be accommodated at each procedure. Depending on the amount of radiation damage and the degree of scarring and contraction anywhere from 3-5 or more fat transfer procedures may be required. What can be expected is continued improvement with restoration of volume and improvement in tissue quality from one procedure to the next. A process of gradually changing Styrofoam to Butter.

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