Methods/Technique: We performed a retrospective review of all reduction mammaplasties and mastopexies in previously irradiated breasts performed by the two senior authors (M.Y.N & S.L.S) from 1995-2012. Patient records were reviewed for demographics, smoking status, chemotherapy and radiation histories, procedures performed, and complications.
Results/Complications: During the study period, 12 reduction mammaplasties and 6 mastopexies were performed. Previous lumpectomy and radiation had been performed on the breasts undergoing these procedures. Average follow-up was 26.3 months. Average patient age was 49.5 years. Average BMI was 29.0. Average pre-operative bra cup size was D/DD. One patient was a former smoker, 17 were non-smokers. Eleven of the 18 patients had been previously treated with chemotherapy. Average time between radiation therapy and surgery was 2.5 years. Average specimen weight in reduction mammaplasties was 623g. A variety of pedicles were used in reductions, including inferior, medial, central mound, superomedial, superolateral, and McKissock. Mastopexies performed employed circumvertical, inferior wedge excision, and free nipple graft techniques. 22% (4/18) of patients experienced a total of 5 minor complications, including delayed healing at the T-junction (3), infection (1), and breast skin necrosis (1). None of these complications required a return to the operating room. One of the 18 patients (6%) experienced a major complication resulting in loss of approximately 50% of the breast which was reconstructed with a latissimus dorsi myocutaneous flap. 94% (17/18) of patients had successful outcomes with achievement of pre-operative goals.
Conclusion: Reduction mammaplasty and mastopexy should be approached with caution in the previously irradiated breast but may still be safely and successfully performed.