Breast Reconstruction Revision After Mastectomy

Breast Reconstruction after Mastectomy Overview

As our practice has evolved we no longer are available for immediate breast reconstruction procedures. With our long experience in breast reconstruction (we introduced this procedure to Lawrence in 1994) we bring this knowledge to revise and correct the breasts of those who have undergone breast reconstruction many years ago or very recently.  While we urge patients to first seek correction with the plastic surgeon who performed the original reconstruction, this is not always possible.  We’re here to help guide you through your decision to correct your breast reconstruction.

40 year old patient with previous R mastectomy and radiation. Reconstructed with R latissimus dorsi flap and tissue expander. At second stage the expander was removed and bilateral silicone implants placed.
40 year old patient with previous R mastectomy and radiation. Reconstructed with R latissimus dorsi flap and tissue expander. At second stage the expander was removed and bilateral silicone implants placed.
40 year old patient with previous R mastectomy and radiation. Reconstructed with R latissimus dorsi flap and tissue expander. At second stage the expander was removed and bilateral silicone implants placed.
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VIEW GALLERY

Why Revise Your Reconstruction?

Patients see us for breast reconstruction revision for a variety of reasons, most commonly:

  • Changes to the reconstructed breast, the normal breast or both associated with aging or weight change.
  • Dissatisfaction with appearance or symmetry following their reconstruction
  • Concerns regarding their implant(s) such as possible rupture, capsular contracture, or displacement.
  • Fat grafting to correct deformities cause by partial mastectomy.
  • The original surgeon has retired,  moved away, or was unresponsive to their concerns

 

We occasionally see patients midway through their reconstructive process for an opinion regarding their care and a possible change of surgeons.  While we are happy to see these patients we generally suggest they discuss their concerns with the surgeon who initiated the reconstruction.  They are often in a better position to finish the process they started.

Your First Visit

At your initial consultation we’ll discuss your concerns, evaluate your breasts, and explain available options.  If you have records from your previous procedures please bring them with you.  We will discuss our recommendations and develop an operative plan. Photographs will be taken and we can initiate the insurance predetermination process.

Types of Revision Techniques

After your evaluation, we can discuss what may be needed for satisfactory correction of your breasts.  There is no “one size fits all” approach to revision surgery, and it requires careful discussion and planning with an experienced plastic surgeon.

Breast asymmetry- solutions

  • Breast reduction on the opposite side
  • Breast lift (mastopexy)
  • Implant placement or exchange
  • Fat grafting for volume enhancement

 

Implant problems- solutions

  • Implant removal and replacement
  • Capsulectomy to remove scar tissue (capsular contracture)
  • Capsulorrhaphy (correction of the implant pocket) to reposition implants

Shape problems- solutions

  • Implant exchange
  • Scar revision
  • Fat grafting

 

A single procedure or several may be performed at a given surgical session. These are typically outpatient procedures with recovery times that range from a few days to 1-2 weeks.

View the Breast Reconstruction Procedure in 3D

Reconstruction Guide

Although we no longer provide immediate reconstruction procedures we have included our guide to reconstruction.  Helping patients understand their original reconstruction may also help them better understand what may be required for revision or correction.

We find that the amount of information presented to patients during consultations can sometimes leave them overwhelmed with the many factors they need to consider. We put together this guide to help summarize the information and considerations involved in choosing a breast reconstruction strategy.

We have been performing breast reconstruction at Lawrence Plastic Surgery since we brought this procedure to Lawrence in 1994 and have used a variety of techniques and strategies over the years to achieve the best results for our patients. We have shifted our focus in recent years and now focus on revision of breast reconstruction procedures.  With revision surgery we will continue to coordinate and collaborate with your breast cancer team to assure the best result possible.

 

Pre-Operation Visit

Once your procedure is scheduled we will set up a pre-op appointment 1-3 weeks before your surgery.  We’ll review your procedure, discuss post op care and instructions, give you your prescriptions, and finalize your paperwork so that everything is ready to go the day of your surgery.

The Surgery

Most of these procedures are performed in the operating room at the Lawrence Surgery Center or Lawrence Memorial Hospital on an outpatient basis and may last 1-3 hours.  Some minor procedures may be performed in our office.

Recovery

Varies by procedure but may range from a few days to 1-2 weeks.  We typically see patients in the office the day following surgery and then 1,3 and 6 weeks after surgery.

Insurance

Insurance coverage for revision procedures varies depending on the condition and the insurance provider.  A predetermination process is required before proceeding if you wish to have this covered by your insurance company. We can initiate this at the time of your consultation.

Financing & Payment Options

For information regarding insurance and payment options, please visit our Financing page. We can give you price information prior to the procedure so you can understand your financial obligations.

Patient Forms

Please fill out paperwork at least 24 hours before your scheduled appointment.

See Patient Forms

Breast Reconstruction Gallery

VISIT RESULTS GALLERY
Case 1
48 year old patient, bilateral TRAM reconstruction following bilateral mastectomies and radiation to L chest.
48 year old patient, bilateral TRAM reconstruction following bilateral mastectomies and radiation to L chest.
48 year old patient, bilateral TRAM reconstruction following bilateral mastectomies and radiation to L chest.
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Case 2
51 year old female underwent immediate reconstruction following bilateral skin/areola/nipple sparing mastectomies using tissue expanders and alloderm. Result is shown after removal of expanders and placement of silicone implants.
51 year old female underwent immediate reconstruction following bilateral skin/areola/nipple sparing mastectomies using tissue expanders and alloderm. Result is shown after removal of expanders and placement of silicone implants.
51 year old female underwent immediate reconstruction following bilateral skin/areola/nipple sparing mastectomies using tissue expanders and alloderm. Result is shown after removal of expanders and placement of silicone implants.
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Case 3
65 year old female with previous R lumpectomy underwent immediate reconstruction of the R breast following a skin sparing mastectomy with placement of a tissue expander and alloderm. 3 months later, the expander was removed, a silicone implant placed on the R, and an augmentation/mastopexy performed on the L for symmetry.
65 year old female with previous R lumpectomy underwent immediate reconstruction of the R breast following a skin sparing mastectomy with placement of a tissue expander and alloderm. 3 months later, the expander was removed, a silicone implant placed on the R, and an augmentation/mastopexy performed on the L for symmetry.
65 year old female with previous R lumpectomy underwent immediate reconstruction of the R breast following a skin sparing mastectomy with placement of a tissue expander and alloderm. 3 months later, the expander was removed, a silicone implant placed on the R, and an augmentation/mastopexy performed on the L for symmetry.
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Case 4
36 year old woman underwent bilateral skin sparing mastectomies and was reconstructed with initial placement of tissue expanders and alloderm. 3 months later the expanders were removed and bilateral silicone implants placed
36 year old woman underwent bilateral skin sparing mastectomies and was reconstructed with initial placement of tissue expanders and alloderm. 3 months later the expanders were removed and bilateral silicone implants placed
36 year old woman underwent bilateral skin sparing mastectomies and was reconstructed with initial placement of tissue expanders and alloderm. 3 months later the expanders were removed and bilateral silicone implants placed
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Case 5
48 year old woman with L mastectomy and radiation 5 years previously. Initial procedure was placement of a tissue expander and latissimus dorsi flap.
In her second operation the tissue expander was replaced with a silicone implant and a R breast reduction performed. Nipple reconstruction was done later as an office procedure.
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Case 6
57 year old patient underwent L mastectomy for cancer and immediate reconstruction using tissue expander and alloderm. Nipple sparing technique could not be used due to location of tumor. At second operation the expander was removed and bilateral silicone implants were placed.
57 year old patient underwent L mastectomy for cancer and immediate reconstruction using tissue expander and alloderm. Nipple sparing technique could not be used due to location of tumor. At second operation the expander was removed and bilateral silicone implants were placed.
57 year old patient underwent L mastectomy for cancer and immediate reconstruction using tissue expander and alloderm. Nipple sparing technique could not be used due to location of tumor. At second operation the expander was removed and bilateral silicone implants were placed.
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Case 7
61 year old woman required a R mastectomy. Immediate reconstruction performed with placement of tissue expander and alloderm. At second operation 4 months later the expander was removed and replace with a silicone implant. Mastopexy for symmetry was performed on the L.
61 year old woman required a R mastectomy. Immediate reconstruction performed with placement of tissue expander and alloderm. At second operation 4 months later the expander was removed and replace with a silicone implant. Mastopexy for symmetry was performed on the L.
61 year old woman required a R mastectomy. Immediate reconstruction performed with placement of tissue expander and alloderm. At second operation 4 months later the expander was removed and replace with a silicone implant. Mastopexy for symmetry was performed on the L.
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Case 8
41 year old patient underwent bilateral skin/nipple/areola sparing mastectomies and immediate reconstruction with tissue expanders and alloderm. Expanders removed and replaced with 800cc silicone implants at second operation.
41 year old patient underwent bilateral skin/nipple/areola sparing mastectomies and immediate reconstruction with tissue expanders and alloderm. Expanders removed and replaced with 800cc silicone implants at second operation.
41 year old patient underwent bilateral skin/nipple/areola sparing mastectomies and immediate reconstruction with tissue expanders and alloderm. Expanders removed and replaced with 800cc silicone implants at second operation.
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Case 9
Patient in late 40’s, TRAM flap reconstruction following skin sparing mastectomy for R breast CA. Underwent L mastopexy and R nipple reconstruction at second stage.
Patient in late 40’s, ,TRAM flap reconstruction following skin sparing mastectomy for R breast CA. Underwent L mastopexy and R nipple reconstruction at second stage.
Patient in late 40’s, ,TRAM flap reconstruction following skin sparing mastectomy for R breast CA. Underwent L mastopexy and R nipple reconstruction at second stage.
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Case 10
Patient in 40’s underwent delayed TRAM flap reconstruction on L following mastectomy. Underwent R mastopexy and L nipple/areolar reconstruction at second stage.
Patient in 40’s underwent delayed TRAM flap reconstruction on L following mastectomy. Underwent R mastopexy and L nipple/areolar reconstruction at second stage.
Patient in 40’s underwent delayed TRAM flap reconstruction on L following mastectomy. Underwent R mastopexy and L nipple/areolar reconstruction at second stage.
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Case 11
Patient in her 40’s underwent bilateral TRAM flaps as a delayed reconstruction
Patient in her 40’s underwent bilateral TRAM flaps as a delayed reconstruction
Patient in her 40’s underwent bilateral TRAM flaps as a delayed reconstruction
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Case 12
Patient in her 40’s underwent immediate bilateral TRAM flap reconstruction.
Patient in her 40’s underwent immediate bilateral TRAM flap reconstruction.
Patient in her 40’s underwent immediate bilateral TRAM flap reconstruction.
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How It Works

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