Even in the best of hands many Breast Reconstruction results may require revision procedures. In most instances the need for revision is for the breast that has been reconstructed with an Implant or in a Breast that has undergone Lumpectomy, radiation and a partial reconstruction. The most common physical findings that my benefit from revision are:
- Breast Asymmetry (one breast larger or more sagging than the other)
- Implant issues including: deflation, displacement, scarring and or rippling on the edge of the implant.
- Loss of proper definition and position of the folds beneath the breast
- Firmest, nodules or indentations because of scarring or tissue damage by radiation.
- Malposition or absence of the nipple areolar complex
- Occasionally a patient wishes that she were a different size
In spite of a possible need for revision surgery after breast reconstruction there is some good news
- Because of the efforts of The American Plastic Surgery Society, the vast majority of insurance carriers have been mandated to cover the revision of the reconstructed breast and the treatment of the opposite breast to attain a symmetrical results.
- There are several recent treatment options that are currently available and may have not been available during your first reconstruction, including: Micro-fat contouring to improve breast contour, the use of a Cellular Mesh to better shape and position the breast and , in most cases, no need for additional scarring for Revision procedures.
The patient below presented with many of the concerns noted above: She had undergone a left mastectomy and an implant reconstruction 5 years prior: There was severe scarring around the implant on the left, asymmetry, malposition of the nipple on the left and a misplaced fold beneath the reconstructed breast. The revision procedure included:
- A repositioning of the fold beneath the left breast
- Replacement and release of scarring around the implant
- Micro-fat injections for contouring of the revised breast
- A breast lift to the right breast to restore symmetry
- Micro-fat contouring of the right breast Implant Exchange