Delayed cosmetic improvement following breast conservation therapy

Remodeling of irradiated breast tissue is technically challenging and often associated with surgical complications. The glandular flaps are poorly vascularized and much less robust, and subsequent scarring and distortion are common in the long term, with progressive deterioration of cosmesis. Where volume asymmetry is the principal issue, a contralateral reduction is probably the best approach and avoids surgical intervention on an irradiated field, unless the radiation damage is not relevant and the patient wishes to undergo reshaping of the irradiated breast and accepts possible complications