Refining the Outcome of Flap Breast Reconstruction
Flap Revision Surgery
Just as breast implant reconstruction is typically done in stages, natural tissue breast reconstruction frequently requires secondary revision surgery to achieve an optimal breast shape. Once healing is complete following the first stage of flap breast reconstruction, any potential contour problems can be identified and addressed.
Our team of plastic surgeons has performed thousands of breast reconstruction procedures, always striving to provide superior, natural-looking results. Each of our surgeons is experienced in performing the revision procedures that are common during the secondary stages of autogenous flap breast reconstruction. To arrange a consultation with our team, please contact Aesthetic Plastic Surgery, PC today.
Revision Procedures after Natural Tissue Breast Reconstruction
Revision surgery may be desired to correct a number of potential issues that can arise following natural tissue or flap breast reconstruction. These include:
- Contour Abnormalities - Problems with flap contour irregularities and flap fullness are the most common reasons for revision of a breast reconstructed with an autogenous flap. Such contour problems may be improved by reshaping the soft tissue of the flap that forms the profile of the reconstructed breast. A breast reconstruction that is too large can be corrected through liposuction or excision of skin. In cases where the flap is too small, the volume can be augmented with the placement of a breast implant or with the use of fat grafting into the flap soft tissue. If the reconstructed breast flap has a “dent” in it or sunken area, the contour can also be improved using fat garfting. To complete this process, fat is harvested with liposuction from elsewhere on the body and injected into the breast. Since the amount of fat that is accepted by the body may differ from patient to patient, more than one fat grafting procedure may be necessary to achieve the desired result.
- Fat Necrosis - If there is inadequate blood supply to parts of the reconstructed flap tissue, areas of fat necrosis may occur. This condition describes the hardening of soft tissue in the reconstructed breast, and can result in the presence of lumps. In some cases, it may be necessary to confirm that a lump or area of firmness is not cancerous. In this case, a biopsy may be needed to identify the presence of fat necrosis. Over time, firmness tends to dissipate, but excision may be necessary if there is discomfort or if there is a visible contour deformity. A common risk factor contributing to the presence of fat necrosis is radiation treatment following breast reconstruction.
- Abdominal Bulges - Although microsurgical and muscle-sparing approaches minimize the risk, natural tissue breast reconstruction techniques utilizing abdominal flaps may contribute to weakness of the abdominal wall. In severe cases, this can cause abdominal bulging or hernias. Surgery needed to repair an abdominal bulge or hernia may require the use of abdominal muscle advancement flaps reinforced with mesh. A safe and reliable approach to the correction of such hernias utilizes external oblique muscle release with internal oblique muscle advancement and an extended mesh repair. This can allow for stable repair of the hernia in addition to an improved abdominal wall contour.
As in the case of revision surgery after implant-based breast reconstruction, in the setting of autogenous flap breast reconstruction, breast revision surgery is usually delayed until any additional treatments such as chemotherapy and radiation are completed. Most flap revision procedures can be done on an outpatient basis and are frequently coordinated with nipple areola reconstruction.
Contact the Plastic Surgeons of the
New York Breast Reconstruction Associates at Aesthetic Plastic Surgery, PC
If you’ve already completed the first stage of your breast reconstruction, we can help you decide if additional surgery can provide you with a more optimal outcome. To arrange an appointment or inquire about your next scheduled appointment, please contact our Long Island, New York plastic surgery office today.