It’s important to give the reconstructed breast time to heal, about 4-6 months, before judging the results. Still, some women may have a small difference in the shape, balance, or position of the reconstructed breast compared to the other breast. Because there are so many variables, there is no real standard approach to fixing minor flaws after reconstruction.
Some common techniques are:
Lipofilling: In lipofilling, fat tissue is removed from another part of your body, your abdomen, for example, processed into liquid in a lab, and then injected into the reconstructed breast to improve its shape or fullness. It’s often used for things like softening and improving the skin over an implant; filling in imperfections; or giving more lift to a flap reconstruction. More and more surgeons are using lipofilling and some health insurance companies are covering it, although getting it covered can still be an issue. Some plans still classify lipofilling as “experimental,” although multiple studies have shown its usefulness.
While some doctors have wondered whether lipofilling would increase the risk of the breast cancer coming back (recurrence), studies done in 2011 and 2016 strongly suggest that women who have lipofilling are no more likely to have a recurrence than women who never had lipofilling.
Dermal matrix products: Dermal matrix products are skin substitutes made from human, calf, or pig skin that has been processed and sterilized to remove all cells, which reduces the risk of disease and your body rejecting it. What’s left is a mesh-like framework of mostly collagen, a strong protein found in skin, bones, and other tissue. Human skin used for dermal matrix products is donated by tissue banks that follow American Association of Tissue Banks Standards. All skin used to make dermal matrix products is tested according to U.S. Food and Drug Administration and appropriate state regulations. There are more than 10 dermal matrix products used in breast reconstruction.
AlloDerm, Strattice, NeoForm, and DermaMatrix are all dermal matrix products. These products have been used in breast reconstruction since about 1998 and are being used more frequently today.
Surgeons use dermal matrix products to fill in ridges or dents that may appear after reconstruction.
A plastic surgeon who's experienced in breast reconstruction can work with you to develop a correction plan that addresses all your concerns and goals.
If these more minor procedures aren’t sufficient, you might consider additional surgery — either on the reconstructed breast(s) or the opposite natural breast — to achieve a better result. Most plastic surgeons recommend that you wait at least 6 months to 1 year after reconstruction before having any more surgery to fix any defects. This allows your tissues to heal and allows any distortion or asymmetry (imbalance) to stabilize. For more information, visit our section on Altering the Opposite Breast.