Revisional Breast Reconstruction Ohio
It is always the hope of the patient and the plastic surgeon that the reconstructive process will proceed in a smooth and complication-free fashion, leading to a final result that is aesthetically in line with the patientâ€™s desires. Unfortunately, reconstructions can occasionally deviate from this perfect path for many reasons:
1. Side Effects Due to Breast Cancer Treatment
The reconstructive plan is often mapped out based on the expected cancer treatment plan. However, the treatment plan can change after the initial operation is done and the final tumor and lymph node characteristics are determined. This can sometimes introduce interventions that may affect the reconstruction.
For example, a patient who has a tissue expander reconstruction after mastectomy is found to have a tumor that would benefit from radiation therapy. Irradiating a tissue expander or implant reconstruction is known to increase the risk for failure of the reconstruction, making it likely that the reconstructive plan will need to be altered to achieve a stable, aesthetically sound result.
Dr. Kocak is a wonderful and skilled Plastic Surgeon. He was warm and professional and his office staff was equally caring......
He's very knowledgeable, honest, kind, and sincere. He made me feel comfortable......
Highly recommend Dr. Kocak. The whole team from front office to Doctor are caring and very professional. They put me at ease on my first visit and were honest, incredibly knowledgeable and detailed with explaining the procedure......
He wants the best for his patients and make sure his patients are informed so that they can make the right decision for them. The staff, as well as Dr Tiwari, are very nice and always helpful......
He is a great surgeon. He answered all my questions. He was very easy to talk to. The procedure went well and my recovery was short and less painful than I thought. The staff is great and made me feel very comfortable! I highly recommend Kocak, heâ??s ......
Dr. Tiwari is an excellent board certified plastic surgeon......
I had a great experience with Dr. Tiwari. He is amazing at what he does, he made me feel beautiful again. His staff was super friendly and welcoming. I am so pleased with the quality of care, the staff and the results......
Dr. Kocak is an amazing doctor. He has the best bedside manner of any doctor I've ever been to. Dr. Kocak is truly an artist in what he does. I highly recommend him. His staff is very well-mannered and expert in what they do......
Dr. Kocak is wonderful! I recently had a breast reconstruction surgery with Dr. Ergun Kocak and it was one of the best decisions I have ever made. I am so contented with the result. He was reassuring every step of the way and explained everything to me and made......
Dr. Kocak & Dr. Tiwari performed my DIEP reconstruction when I had my prophylactic double mastectomy due to having a BRCA1 mutation. Their excellent surgical skills are equally matched by their compassion, accessibility, and dedication to their patients. Their confidence and guidance led me ......
Dr. Kocak and Dr. Tiwari are amazing surgeons. Â They are caring, thorough, easy to get in contact with for questions and all around great doctors. Â After many years of painful, deformed implant reconstruction I chose to have the DIEP flap reconstruction, Drs. Tiwari and Kocak did a great job......
2. Complications Relating to the Original Reconstruction
Every operation, however big or small, is associated with potential complications. That said, most operations also have potential benefits. That is why for elective procedures such as breast reconstruction, it is critical that each patient understands not just the benefits, but the potential problems that could come with any plan.
If a complication leads to a compromise in the reconstruction itself, it could lead to an unfavorable or unacceptable cosmetic outcome. Even worse, some complications can lead to failure of the reconstruction all together. For example, if an implant reconstruction becomes infected, antibiotics may clear the infection. Alternately, the infection may progress and surgical intervention may be indicated to salvage or remove the implant all together. While not always life-threatening, such complications can lead to long-term asymmetry or even failure of a reconstruction.
3. A good outcome that doesnâ€™t fit the patientâ€™s goals
Many of the studies that are done to evaluate the outcomes of breast reconstruction use failure of the reconstruction or the need for additional surgery as an endpoint. While this makes it much easier to catch such events, it does not capture the cases where patients have endured a sometimes long and challenging reconstructive pathway only to end up with a result that is not what they had hoped for. There are many reasons a patient might not be satisfied with their reconstruction:
- Reconstructed breast is higher/lower than the natural breast on the other side
- Reconstructed breast is bigger/smaller than the natural breast on the other side
- Reconstructed breast is higher/lower than the reconstructed breast on the other side
- Reconstructed breast is bigger/smaller than the reconstructed breast on the other side
- Reconstructed breasts are too big/too small for a patientâ€™s frame
- Lumpy areas
- Rippling of an implant
- Lack of volume where volume should be present
- Excess volume where volume should not be too excessive
- Hard/firm spots
- Asymmetry of nipple position/orientation
- Inframammary fold malposition
Many of the above issues can be subtle to an examiner or in photographs, but may be very noticeable to the patient and cause significant psychological stress and concern. Fortunately, many of these issues can also be improved in the hands of experienced surgeons who specialize in reconstructive surgery of the breast.
There are several different methods that can be used to accomplish reconstruction. For this reason, if one method does not produce an ideal result, alternate options can be evaluated. Even if the initial reconstructive pathway was long and utilized many of the potential donor sites, it is still possible that a viable option exists and a stable, acceptable reconstruction can be achieved.
Several factors contribute to successful correction of a previously failed or unsatisfactory reconstruction. A detailed history and documentation of previous operations is critical in assessing which options are still available or have been exhausted. It also requires careful consideration of the risks and benefits of each possible scenario. Finally, the surgeon and surgical team must be comfortable with the full range of techniques, ranging from implant-based reconstructions to microsurgical transfer of perforator-based tissue flaps. With careful planning and attention to the patientâ€™s goals, major improvements can be made and satisfaction can be achieved in many cases.
If you are in need of Revisional/Redo Breast Reconstruction and are based in Indiana, Kentucky or another surrounding state, click here to experience superior surgical skills and unparalleled patient care from Midwest Breast & Aesthetic Surgery.
Frequently Asked Questions about Corrective or Redo Breast Reconstruction
Iâ€™ve already had a breast reconstruction. Am I a candidate for redo or corrective breast reconstruction?
In most cases, even if several previous operations have failed to produce a stable and symmetrical breast reconstruction, additional options to either correct the existing reconstruction and/or establish a new breast reconstruction are usually available.
Which operation(s) will be used for my corrective or redo breast reconstruction?
The specific operations that can be used for corrective or redo breast reconstruction depend largely on the type of reconstruction that was done in the first place. Sometimes, the existing reconstruction can be modified to obtain a more symmetrical or favorable result. In other cases, an entirely new attempt to create a long-lasting, symmetrical breast reconstruction may be the only option. Correcting a previous reconstruction can be technically demanding and will often involve advanced operative techniques such as microsurgery. Not all plastic surgeons specialize in these techniques, so be sure to find a surgeon who is comfortable with the full spectrum of breast reconstructive operations.
How long will I need to be in the hospital after my revision surgery?
The expected hospital stay associated with a redo or corrective procedure depends largely on the operation being done. Many smaller procedures, such as modification of an existing reconstruction with adjustment of an implant or autologous fat grafting, can be accomplished with a minimal hospital stay or even in the outpatient setting. On the other hand, if a reconstruction is being redone completely, operations such as the DIEP flap may be necessary. These procedures generally require longer hospital stays of approximately three nights. Each of the specific procedures and their associated hospital and recovery times can be found here.
How long will my recovery take after corrective or redo breast reconstruction surgery?
Recovery also depends on the type of operation that are needed to accomplish the desired corrections. Smaller procedures, such as changing implants or small volume fat grafting, require minimal recovery periods, ranging from one to three weeks. More extensive procedures, such as the DIEP flap, require longer recovery periods, ranging from four to six weeks. Details pertaining to the specific procedures can be found on our Breast Reconstruction information page.
Will my insurance cover additional surgery?
If a patient has pain, asymmetry, and/or deformity of their breast reconstruction, most insurances will cover the operations needed to accomplish a stable, long-lasting, and symmetrical result. This is based on requirements outlined by the Womenâ€™s Health and Cancer Rights Act of 1998 (WHCRA). More information can be found on our Resources page and by reading Dr. Kâ€™s previous blog entry here.
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