Revision Breast Reconstruction

ON LONG ISLAND

Breast reconstruction surgery can help women restore their self image, regain their confidence, and feel more comfortable when they’re dealing with breast cancer treatment. As you consider your options, you’ll want to work with a practice that offers an experienced surgical team and a knowledgeable patient coordination staff to help.

Harris Plastic Surgery is one of the best options for breast reconstruction in New York because we offer both the clinical and administrative support you need.

Approaches to Breast Reconstruction

Your breast reconstruction needs will change depending on the type of cancer surgery you’ve had and whether radiation was involved. Radiation can affect the timing of your surgery as well as the type you can have. Very broadly, there are two types of breast reconstruction surgeries:

The choice between tissue-based and implant-based breast reconstruction depends on the patient’s individual needs, anatomy, and desired outcome as well as the surgeon’s expertise and recommendations.

There’s also another component of breast reconstruction to consider, and that’s timing. Breast implant surgery used to be completed in stages; however, advances in medicine have allowed us to offer direct-to-implant options as well.

Breast asymmetry:
Scar tissue can form differently in each breast, resulting in asymmetry. Infections and implant displacement can aggravate this even more.

Breast deformity:
Lumpectomies and radiation therapy can lead to localized contour depressions or “divots” in the skin, causing deformity in the breast.

Implant hardness:
Scar tissue is often the culprit when implants feel hard because the scar compresses and displaces the implants, causing them to displace and tighten.

Implant ruptures:
Breast implants aren’t meant to last a lifetime, and there is the possibility that they could rupture or leak. A rupture of the implant can cause pain, swelling, and changes in the appearance and shape of the breast, but with silicone implants, a silent asymptomatic rupture might also occur.

Nipple displacement:
Nipple displacement can also be caused by localized tissue deficiencies and scar tissue.

Chronic discomfort:
Many revision breast reconstruction patients are more concerned with the way they feel than the way they look. We frequently see women with chronic discomfort resulting from implant reconstruction where the implant was placed partially under the muscle. That can create a deformity that causes pain whenever that muscle contracts, called a “dynamic deformity.”

It can take years for many of these issues to become evident for someone who has had a breast reconstruction. Regardless of how long it’s been, there’s almost always a way to improve it. At Harris Plastic Surgery, we use a number of proven techniques to help our patients.

Autologous Fat Grafting
Autologous fat grafting is a common procedure with many uses in revisional breast surgery. It involves taking fat from another part of the body, like the stomach or thighs, using a small liposuction cannula, and then injecting it into the breast to improve its appearance. This can be used to fix uneven areas, soften the contours around the implants, make the breast feel softer around an implant, hide any visible lines or ripples from the implant, or add a little extra volume for a better overall result.

Prepectoral Revision Reconstruction 
During a prepectoral revision reconstruction surgery, old breast reconstruction scars are removed. Then, a new space is created above the pectoralis muscle to place a new breast implant, recreating the original mastectomy space. The old implant is removed, and the chest muscles are reattached to the chest wall using sutures . The new implant is placed in the new pocket. To help prevent visibility, a sheet of human donor-derived collagen, called acellular dermal matrix, is sometimes used to cover or wrap the new implant to provide additional support and reduce the risk of scarring.

Internal Implant Pocket Refinement 
At the time of the original reconstruction, a pocket is created for placing the implant; however, over time, the implant may shift inside this pocket, resulting in asymmetry and deformity. An internal implant pocket refinement, or capsulorrhaphy, is a surgical technique used to adjust the position of a breast implant to correct this. At times, implantable biologic scaffolds made of dissolvable material are used to prevent recurrence.

Scar Revision
Scars can lead to skin puckering and deformities that cause breast asymmetry and nipple displacement. In scar revision surgery, we surgically adjust the scar to release the tension it’s causing and help create a more uniform appearance.

Replacement of Ruptured Implants 
In this surgical approach, we remove the ruptured breast implant. We then replace the implant with a new one. This is done in a single surgery.

Implant Conversion to Natural Tissue Reconstruction 
Sometimes, a patient who has previously had a breast implant would like to have it removed but not replaced with another breast implant. In this case, the surgeon removes the implant and then uses tissue from another part of the patient’s body to create a new breast. This helps create a more natural appearance while eliminating the risk of future implant ruptures.

Direct-to-Implant

 

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Staged Reconstruction

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Direct-to-implant (DTI) reconstruction is a type of breast reconstruction surgery that involves placing a breast implant immediately after the mastectomy, without the need for tissue expanders. During the procedure, the surgeon removes the breast tissue and creates a pocket for the implant in the chest. Then, the implant is placed in the pocket, and the incisions are closed.

In this multi-stage process, the surgeon places an expander to create a pocket where the permanent implant will go. The expander is gradually increased with saline solution over the next few months to stretch the skin and soft tissue. Once sufficient room has been created, the permanent implant is inserted. 

Pros

 

  • Fewer surgeries

  • Faster recovery

  • More immediate results

Cons

 

  • Implant size limitations

  • Not suitable for all cases

Pros

 

  • More natural result

  • Less scarring

  • More implant size options

Cons

 

  • Longer recovery

  • Multiple surgeries

  • Increases risk of complications

What You Need to Know About Funding Your Surgery

Many women avoid pursuing a revision breast reconstruction due to misperceptions of out-of-pocket cost. However, if your initial breast reconstruction was covered by your insurance, then revision breast reconstruction is usually covered as well. This is because of federal and state laws. The Women’s Health and Cancer Rights Act of 1998 mandates insurance coverage for breast reconstruction and revision breast reconstruction related to mastectomies.

Our office is very familiar with that law as well as the insurance policies affected by it. We’re able to walk our patients through the steps to getting their surgery financed so they can reduce any out-of-pocket costs.

The Best Choice for Revision Breast Reconstruction on Long Island

There are a lot of options for revision breast reconstruction on Long Island, but not many plastic surgeons take the full-service approach that we do. Our expert medical team works with you to understand your goals with surgery, recovery concerns, and medical history so we can guide you to the right treatment choices. While many doctors can provide breast reconstruction, we focus on total well-being. We don’t just want you to have a better aesthetic—we want to help improve your life.

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Considerations in Revision Breast Reconstruction

If you’re interested in discussing your revision breast reconstruction surgery options, feel free to contact us for a consultation. We can provide all the information you need to make the right decision.