Secondary Revision of Unsatisfactory Breast Reconstructions

ABSTRACT

To perform successful esthetic breast reconstruction requires careful planning. When presented with a secondary reconstruction, many reconstructive options are no longer available, making the planning more challenging. The options include autologous reconstruction using a latissimus dorsi or transverse rectus abdominis myocutaneous flap and expander/implant reconstruction. Frequently, the reconstruction uses a combination of these techniques. Four tenets will be presented to help decide which reconstructive option is best for an individual patient based on skin and soft tissue, anatomic landmarks, symmetry, and unique patient issues. The key to a successful outcome in revisionary breast surgery is proper patient selection. Frequently the etiology of the failure of the original reconstruction was not due to surgical technique but to a failure to choose the correct operation for a specific patient.

Keywords

Patient selection - modifying existing results - procedure selection