The goal of corrective (or “revision”) surgery is to fix problems that occurred during or after breast reconstruction surgery that impact your quality of life or your health.
You might choose to have corrective surgery because a previous attempt at breast reconstruction failed completely — for example, you had to have your breast implants removed due to infection. Another reason could be that your mastectomy or reconstruction was performed in a way that left you with poor cosmetic results. Or you might have developed a complication over time, such as a rupture in an implant or a hernia in the area of the abdomen where you had tissue removed to rebuild your breast.
If you’re unhappy with the results of a reconstruction surgery or you’re having symptoms that could mean you developed a complication, it’s worth seeking out a plastic surgeon who has a lot of experience with corrective procedures and finding out about your options.
Symptoms of a complication after breast reconstruction can include:
- breast pain or discomfort
- increasing tightness or firmness of the reconstructed breast
- changes in the shape, size, or position of the breast
- breast implant is not in the correct position
- a lump or area of firmness in the breast
Corrective surgery is always customized to your unique situation. Your options will depend on what happened when you had reconstruction surgery in the past. For instance, if you want to rebuild a breast that lost some skin due to tissue breakdown or infection, you may need to use a flap of tissue taken from another part of your body rather than an implant. If you already had tissue taken from a donor site on your body (such as your belly) for an earlier attempt at reconstruction, then you may need to use a different donor site (such as your buttocks) if you want to have another tissue-based reconstruction procedure.
On these pages, you can learn about procedures to repair problems related to mastectomy and breast reconstruction. If you’re looking for information about correcting problems that occurred because of a lumpectomy, see Reconstruction After Lumpectomy.
Learn more about:
- Reasons for corrective surgery
- Timing of corrective surgery
- How to find a plastic surgeon for corrective surgery
- Paying for corrective surgery
- Risks of corrective surgery
Reasons for corrective breast reconstruction
Corrective surgery can address problems that sometimes develop after breast reconstruction surgery such as pain, imbalance between the breasts, or displacement of an implant. You may have multiple problems that you’d like to have corrected. Your plastic surgeon will work with you to come up with a correction plan that’s customized to your unique situation.
Complications with breast implants
Breast implants usually don't last a lifetime. Women who have had implant reconstruction commonly have one or more surgeries at some point because of a complication or to improve how their breasts look and feel. The longer you have implants, the greater the chance that they will develop a complication. Keep in mind, though, that implants don’t have an expiration date and there’s no need to replace them unless you have a problem.
Some of the complications that can lead to the need for additional surgery include:
- Implant displacement
- Dynamic distortion
- Capsular contracture
- Implant rupture
- Implant extrusion
Complications that can occur with breast implants or other kinds of reconstruction
The following complications can happen after flap (or autologous) reconstruction and in some cases after implant reconstruction:
- Necrosis of the breast skin related to the mastectomy
- Necrosis of the tissue flap
- Fat necrosis
- Radiation therapy effects
- Breast asymmetry
- Nipple reconstruction problems
- Hernia after TRAM flap or DIEP flap reconstruction
Timing of corrective surgery
Corrective surgery can happen soon after an initial reconstruction surgery or years later.
In some cases, your plastic surgeon may recommend that you wait a few months after your initial reconstruction surgery to see if a defect that is bothering you disappears on its own. It’s normal for there to be some swelling, wrinkling, imbalance, or other minor distortions in the appearance of the breasts while the tissues heal. If you have breast implants, they may take a few months to “settle” into position.
Also, if you’re still undergoing radiation or chemotherapy, you will need to complete those treatments before you have a corrective procedure.
How to find a plastic surgeon for corrective surgery
Plastic surgeons vary widely in their level of skill and the types of procedures they can perform. If you’re considering corrective surgery, spend some time searching for a highly skilled plastic surgeon who has a lot of experience performing reconstructive and corrective breast procedures. Corrective surgery presents different challenges than a first-time reconstruction or a breast augmentation.
It may be helpful to reach out to other people who had corrective surgery for advice on finding a surgeon. You can connect with people who had or are considering corrective surgery through the Breastcancer.org online Community or other web-based or in-person breast cancer support groups. As you begin your research, keep in mind that corrective surgery goes by a variety of names. You might see it referred to as “revised reconstruction,” “revision surgery,” “redo reconstruction,” or “botched breast reconstruction repair.”
Schedule initial consultations with the plastic surgeons you’re interested in. During each consultation, don’t hesitate to ask direct questions about how many reconstructions the plastic surgeon has revised, and ask to see before-and-after photos. For more tips, see our page on Finding a Qualified Plastic Surgeon.
Since many parts of the country lack plastic surgeons with expertise in corrective surgery, you may decide to travel to another city or state to find the right surgeon. If you’re considering traveling for surgery, check with your health insurance provider to see if your medical expenses will be covered. Health insurance plans usually don’t cover travel costs.
Paying for corrective surgery
Health insurance usually covers corrective breast reconstruction surgery. You might need to work with your plastic surgeon’s office or directly with your insurance company to communicate that the surgery is medically necessary — not just cosmetic — and get approval.
Be sure to ask up front if any plastic surgeon you’re considering accepts health insurance — some do not. Some surgeons who do accept insurance may expect patients to handle more of the paperwork or phone calls that might be required to get the insurance to pay for the procedure. It’s best to ask early on about what to expect.
You may be thinking of traveling to a plastic surgeon who specializes in a type of corrective surgery that’s not available in your community or choosing a surgeon who is outside your health insurance plan’s network. If that’s the case, find out which expenses your plan will cover. Health insurance plans typically don’t cover travel costs. Also, ask the plastic surgeon if you will need to have more than one procedure to get the best results. You may find that you’ll be traveling multiple times for procedures and that you’ll want to budget for any out-of-pocket travel expenses. For more tips about managing costs, see our page on Paying for Reconstruction Procedures.
Risks of corrective surgery
In general, the risks of corrective surgery are the same as those of primary reconstruction surgery. For example, risks may include infection in the area of the surgery, loss of skin, unexpected scarring, problems with anesthesia, and wound healing problems like hematoma (blood collecting in a surgical wound) or seroma (clear fluid collecting in a surgical wound).
If you have diabetes, circulatory problems, a bleeding disorder, or you’re a smoker, it may take your body longer to heal from corrective surgery. Smokers are often advised to avoid all nicotine-containing products for as much time as possible before undergoing corrective surgery.
You may be at increased risk of having a complication from corrective surgery if you had multiple breast surgeries in the past that caused scarring, thinned skin, or other damage to the breast tissue.
Talk with your plastic surgeon about whether there are any special risks to consider in your personal situation.
The medical experts for Corrective Breast Reconstruction are:
Frank J. DellaCroce, M.D., FACS, plastic surgeon, co-founder of the Center for Restorative Breast Surgery and the St. Charles Surgical Hospital, New Orleans, LA
Scott K. Sullivan, M.D., FACS, plastic surgeon, co-founder of the Center for Restorative Breast Surgery and the St. Charles Surgical Hospital, New Orleans, LA
William L. Scarlett, DO, FACS, FACOS, FAACS, plastic surgeon, chief of surgery and director of surgical services at Holy Redeemer Hospital in Bensalem, PA
Joseph M. Serletti, M.D., FACS, plastic surgeon, chief of the Division of Plastic Surgery at Penn Medicine, Philadelphia, PA
Beth Baughman DuPree, M.D., FACS, general surgeon specializing in diseases of the breast, medical director of the oncology service line at Northern Arizona Healthcare in Sedona, AZ
Tommaso Addona, M.D., FACS, plastic surgeon, president of Long Island Plastic Surgical Group and chief of plastic surgery at St. Joseph Hospital in Bethpage, NY