Summary
Revision surgery procedures can improve breast volume and contour after natural tissue breast reconstruction. These procedures can be done once the reconstructed breast has healed, although surgery is usually delayed until any additional treatments, such as chemotherapy or radiation, are completed. Most flap revision procedures can be done on an outpatient basis and are frequently coordinated with nipple areola reconstruction.
Types of Procedures
- Liposuction: A breast reconstruction that is too large can be corrected through liposuction or excision of skin.
- Fat Grafting: Flap volume can be augmented by harvesting fat from elsewhere on the body and injecting it into the reconstructed breast. This process, called fat grafting, can also improve contour if a reconstructed breast flap has depressed or sunken areas.
- Implant Placement: Flap volume can be augmented with the placement of a breast implant. The implant is added to a natural tissue flap to improve the size and shape of a reconstructed breast.
- Lump Excision: Fat necrosis may occur if there is inadequate blood supply to reconstructed flap tissue. This condition can result in the presence of lumps, which may be removed if they cause discomfort or visible deformity. Radiation treatment following breast reconstruction can increase the risk of developing fat necrosis.
- Abdominal Bulge or Hernia Repair: Natural tissue breast reconstruction techniques that use abdominal flaps may contribute to abdominal wall weakness, which can cause abdominal bulging or hernias in some cases. We offer a safe and reliable approach to the repair of abdominal flap donor site hernias.
Procedure Details
- Most flap revision procedures are performed on an outpatient basis
- Procedure type depends on what changes or improvements are desired
- Flap revision surgery can frequently be coordinated with nipple reconstruction
- Revision procedures should be delayed until any additional treatments, such as chemotherapy and radiation, are completed
- Otherwise, revision surgery may be done at any time after the reconstructed breast has healed
Risks & Benefits
Flap revision surgery is usually done safely as an outpatient procedure with a recovery period that is much easier than the initial mastectomy and breast reconstruction surgery. The specific risks depend on what type of revision procedure is being done. As you plan the next stages of your breast reconstruction, our surgeon will help guide your decisions so that you understand your options and can achieve the best possible results.
Frequently Asked Questions
I had breast reconstruction with DIEP flaps. Can I be bigger if I still want to avoid implants?
Fat grafting can be done to increase breast size or improve breast contour after natural tissue reconstruction. To avoid using implants, multiple staged fat grafting procedures may be needed to provide a significant increase in breast size.
Will my insurance company consider revision surgery as cosmetic?
The best outcomes in breast reconstruction frequently require staged surgery. As such, insurance companies do not consider revision procedures to be cosmetic. In fact, the Women’s Health and Cancer Rights Act of 1998 mandates that insurance companies provide coverage for all stages of breast reconstruction, including revision procedures.
