Revision Breast Reconstruction

Occasionally, a patient will present with a breast deformity related to lumpectomy and radiation therapy. These deformities are characterized by localized tissue deficiencies or contour depressions, and nipple displacement and breast size asymmetry is not uncommon as well.

A patient may also undergo implant-based breast reconstruction and develop a problem in the postoperative period, such as implant infection leading to immediate failure of the reconstruction and removal of the implant. Similarly, some patients who undergo tissue-based reconstruction may have partial tissue loss leading to contour depressions or asymmetries after breast reconstruction. Not uncommonly, implant and tissue reconstruction will require small revisional procedures, performed as an outpatient to salvage or improve the reconstructive outcome.

Autologous fat grafting is a commonly used procedure with many uses in revisional breast surgery. Fat is harvested by liposuction from a donor site in the torso or thighs and is prepared and reinjected into the breast to correct contour depressions, soften the implant-chest wall interface, camouflage visible rippling of underlying implants, or to strategically add volume for finesse refinement of the result.

Implant exchange, internal refinement to the implant pocket, and scar revision are also commonly performed to improve the suboptimal result after breast reconstruction.

Based on the Women’s Health and Cancer Reconstruction Act, a federal law enacted in 1998, these revision procedures are considered part of the reconstruction and these federal mandates ensure insurance coverage.