ABSTRACT
Breast reconstruction can be autologous or non-autologous, or a combination of the two. The type and timing of the reconstruction is affected by patient factors, but also by anticipated need for adjuvant or previous breast radiotherapy. The effects of radiation on the skin are categorised into acute and chronic, thereby causing post-operative morbidities across a long time-span. The harmful effects of adjuvant radiotherapy on implants include capsular contracture, implant gel leakage and implant rupture. Biological matrixes, such as acellular dermal matrix, may be useful in the setting of anticipated adjuvant radiotherapy by protecting adjacent soft tissue from radiation injury delivered post-operatively. A small cohort study on the effect of timing of radiation therapy on reconstruction with lattisimus dorsi flaps and implants found a trend towards better long-term cosmetic outcome in patients undergoing delayed reconstruction, with volume and contour of the upper pole being most negatively affected by radiation.
