Bookmark This Page

The Effects of Previous Unilateral Breast Radiation Treatments On Bilateral Breast Reconstruction Using Tissue Expanders

Posted on December 27, 2009 in Breast Cancer, Breast Reconstruction, Radiation Treatments, Tissue Expanders

Women who undergo bilateral breast reconstruction have the best possible chance of obtaining relatively symmetrical results. This would be independent of the technique employed, whether it is immediate insertion of implants, utilization of tissue expanders or flap procedures such as a TRAM flap.

A significant exception to this would be unilateral radiation treatments as adjunct therapy for breast cancer. As I described in a previous post (Tissue Expansion for Breast Reconstruction Can Be Challenging In Women With Previous Radiation Therapy), radiation treatment causes permanent damage to the skin and underlying tissues resulting in scarring, thickening and rigidity often with some associated change of skin color and texture. It does impede the ability to stretch the skin as is required for breast reconstruction using tissue expanders and will substantially affect the final outcome.

The following patient of mine exemplifies this effect. She underwent a bilateral mastectomy and unilateral radiation treatments on the left side. This converted a situation that could have provided her with relatively symmetrical results to one in which this was an impossibility. The method of breast reconstruction that she chose was to use tissue expanders.

a.) Bilateral mastectomy and left breast irradiation. Preoperative

b.) Postoperative insertion and inflation of tissue expanders

c.) Preoperative

d.) Postoperative

e.) Preoperative

f.) Postoperative

Identical tissue expanders were inserted on both sides with the radiated side requiring a greater amount of inflation to reach what appears to be a less substantial sized mound. This is a clear manifestation of the effects of radiation on the tissues.

If you have some questions with regards to breast reconstruction, breast implants or any other plastic surgery procedure that I perform or if you would like to schedule a consultation with me, you can contact my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

An Uncommon Outcome From Breast Augmentation: Symmastia (Uniboob)

Posted on December 1, 2009 in Breast Augmentation, Breast Implants, Symmastia

Though the results from a breast augmentation are generally excellent with a satisfaction rate well over 90 percent, complications and less than desirable results do occur. One of the less common problems that can occur is where the breasts are so close together that they seem to coalesce into one breast unit. This is called symmastia (or synmastia) or in pseudo lay terms, a uniboob.

Symmastia of breasts

Symmastia of breasts

What are the causes of this deformity known as symmastia? Usually this is the result of attempting to move the breasts closer together in order to obtain improved cleavage. The pockets for the implants are dissected too far toward the midline which detaches the skin and underlying tissue from adhering to the sternum. The skin then drapes over the breast implants without having a discrete attachment to the sternum creating this amorphous “uniboob”. The situation is further exacerbated with implants that are inappropriately sized for the woman’s dimensions. Symmastia can occur both with breast implants placed in front of and behind the pectoralis major (chest wall) muscle.

Women who are very thin do have a slightly greater risk of this deformity occurring as do those who have a chest wall deformity known as pectus excavatum (where the sternum has a caved in appearance). Very conservative dissection in these situations and avoiding disproportionately large breast implants can help to minimize the development of symmastia.

There are several approaches which have been employed to address this challenging deformity. A relatively new technique involving the placement of specially processed tissue (Alloderm® and Strattice®) offer the potential of more predictable, satisfactory and permanent results.

For more information on symmastia, breast implants, breast augmentation or any other cosmetic surgery procedure or to schedule a consultation, you can call my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

Visit Our
Post Surgery
Recovery Products Store

Click Here