CORRECTIONS AFTER RECONSTRUCTION

Many breast cancer patients who have had previous breast cancer reconstruction surgery are unhappy with their results, now in need of breast reconstruction revision. This can involve anything from fine-tuning to an entirely new reconstruction depending on the specific situation.

The reasons for unsatisfactory results are:

 

• some women were treated years ago before new surgically advanced techniques were available

• time takes its toll and while years pass by good results change to unacceptable ones due to natural processes of healing and changes in body weight

• implant-related complications (extrusion, rippling, rupture, capsular contracture, infection)

• imitations to reconstruction: additional cancer treatment (radiation), type of mastectomy, patient characteristics (body weight, comorbidities)
  
  

Common complaints are:

 

• asymmetrical breasts

• divots or hollows

• badly positioned implants

• large and unsightly scars

• undefined submammary fold

• capsular contracture (hardening around the implant)

• rippling (visible wrinkling around the implant)

• contour defects and unsightly scars on donor area (after tissue harvesting)

• pain in the reconstructed breast or donor area
  
  

Options for revision surgery:

 

• removing implants and changing for your own tissue

Most of the patients we see for revision surgery have ongoing issues after implant reconstruction.  Complications include capsular contracture, significant breast asymmetry, chronic pain and even infection. In these situations, we usually recommend removal of the implant and surrounding scar tissue, and further reconstruction using the patient’s tissue which creates a natural, soft and warm breast. Almost every patient even the thinnest can have autologous breast reconstruction.

 

• corrections after autologous tissue transfer

There are also patients who are unsatisfied with their flap reconstruction results.  The corrective surgery required depends on the severity of the problem.  Procedures frequently include scar revision, fat transfer- lipofilling, breast reshaping, correction of the donor site or even further flap procedures.

 

• fat transfer (lipofilling)

Fat grafting is frequently used in conjunction with techniques to optimize breast contour and improve the final cosmetic outcome after implant-based or autologous reconstruction. Nowadays it is very commonly used in revision or corrective breast surgery.

 

• re-contouring of the donor site (tummy, buttock, thigh or back)

Breast reconstruction using abdominal or thigh flaps can change the contour of the donor area. Revision surgery can improve the shape and contour as well as scars and provide the best cosmetic results.

 

• scar revision

Scar revision surgery can reduce the appearance of scarring on the reconstructed breast or donor site after tissue harvesting. The procedure can be performed on an outpatient basis in an office setting or the operating room depending on the extent of surgery planned.