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:
Sculptra and similar fillers: Sculptra is the brand name of injectable poly-l-lactic acid. It’s approved by the U.S. Food and Drug Administration to correct the signs of fat loss in the face in people with HIV. It’s also used by plastic surgeons to fill in wrinkles in the face, neck, and hands.
During mastectomy, your surgeon will remove tissue up to the collar bone, but an implant will cover only the breast area. In some cases, there may be a hollow area just above the reconstructed breast or a visible line under the skin where the implant starts. To fix these defects, a surgeon can inject Sculptra into the area to fill in the hollow and create a smooth contour between the implant and the chest.
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.
Lipofilling is more common in Europe than it is in the United States.
While some doctors have wondered whether lipofilling would increase the risk of the breast cancer coming back (recurrence), research done in 2011 suggests that women who have lipofilling after reconstruction 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.
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 to stabilize.