Can breast reconstruction be revised because I'm unhappy with the size? (photos)

Question

I was diagnosed with BC 6 years ago. I have recently under gone breast reconstructionwith Latissimus Dorsi muscle with silicone implant. 6 years ago I had radiation to my left breast. I have 600cc's on left and 500 on right. They seem too small. Can I have revision surgery to enlarge my breasts? If so, how do I approach my PS about this? I initially told him I wanted to be a full C or D.

Donovan Rosas, MD · Answer

Ultimately, patients have the final say in their reconstruction. I would recommend discussing your concerns with your board certified plastic surgeon.While it is your choice, there are some limitations. The largest silicone implants are 800cc. There is autologous fat grafting as an alternative although this is relatively less predictable than an implant. Another limitation is patient anatomy. Sometimes a larger implant won't fit within the dimensions of a narrow chested individual. I also caution patients with thin skin/tissues which might not be able to support a much larger implants.Finally, radiation can compromise the quality of the tissue. It may become stiff and unyielding. In these cases, I recommend patients consider an autologous flap reconstruction (as it removes the compromised skin from the equation).

Anna Steve, MD · Answer

If you feel your breast reconstruction is too small, breast reconstruction revision surgery can be performed to increase the volume of your reconstruction. The most common way to address size is to increase the volume of the implant, or to add an implant in cases where only a tissue-based (flap based reconstruction) was performed.

There are some limitations, for safety reasons, particular in previously radiated reconstructed breasts, as radiation changes can increase the risk of complications in any type of secondary surgery.

Women who are unhappy with their aesthetic outcomes after breast reconstruction surgery often feel as if they are still on their breast cancer journey. It is also normal to feel conflicted because part of you remains grateful that you are cancer-free. This is not a reason to 'settle' for aesthetic outcomes that you are unhappy with. If you are unhappy with your breast aesthetics it is worth speaking to a plastic surgeon about options for how to achieve your goals.

Darryl J. Blinski, MD · Answer

Always best to be honest with for surgeon and tell him you are not completely satisfied. Additional sized implants or even fat grating might help...

Jeffrey Zwiren, MD · Answer

A larger implant may be a choice for you and your plastic surgeon to consider.  The largest implant made is a 800 cc so you may only go up about one cup size.

Jacqueline Anne Luong, MD · Answer

You certainly can undergo a revision to your reconstruction and it is not uncommon to have to undergo a revision.  Discuss your concerns with your plastic surgeon and if he/she is not receptive, get a second opinion.

Steven Wallach, MD · Answer

You need to review things with your surgeon to figure out whether or not your chest wall diameter can handle a larger implant. Best of luck.

Can breast reconstruction be revised because I'm unhappy with the size? (photos)

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