What is Breast Reconstruction Revision?

Breast reconstruction is a surgical procedure that restores your breast after you've had a mastectomy or lumpectomy to treat breast cancer — or if you're unhappy with the results of previous breast reconstruction surgery. For example, if you had implant-based reconstruction, an infection can necessitate removal of implants, or your implants can shift. If you had autologous flap reconstruction, you might not be pleased with your breast shape or symmetry.

Corrective surgery can happen soon after your reconstruction surgery, or much later. If you’re experiencing any of the following issues or aren’t happy with the look of your breasts after reconstruction surgery, the team at Rush can perform corrective procedures that will help you return to looking and feeling your best:

• A lump or area of excessive firmness
• Breast asymmetry
• Breast pain or discomfort
• Changes in breast size, shape or position
• Feeling of chest tightness
• Shift in the position of the implant, or an implant that was never positioned correctly

The expert breast reconstruction surgery team at RUSH works closely with you to understand your goals for size, shape and appearance, and to ensure that your surgery gives you the beautiful breasts you want.

Types of Breast Reconstruction Available at RUSH

Your breast reconstruction experience starts with a conversation with your breast surgeon and your reconstructive surgeon about your goals for your breasts' appearance and the kind of surgery that makes sense for you.

Depending on your overall health, cancer treatment plan and other factors, you might have reconstruction at the same time as your mastectomy or lumpectomy, or might choose to delay it. Your surgeons will help you decide.

Reconstruction options available at RUSH include the following:

Autologous reconstruction uses a flap of your own tissue, taken from another part of your body (most commonly the abdomen). It gives you a soft, natural-looking breast using your own body tissue. Your reconstructive surgeon will determine if you are an appropriate candidate. There are different types of flap procedures:

• Pedicled flap surgery: The tissue stays partly attached to the donor site and is moved to your chest with that blood supply intact.
• Free flap surgery: The tissue is completely removed and transplanted to your breast — a complex procedure that requires specialized microvascular surgery to attach the blood vessels in the tissue to the vessels in its new location. RUSH is one of only a handful of Chicago-area health systems offering this surgery.
• TRAM flap reconstruction: This uses tissue from the transverse rectus abdominis muscle in your lower abdomen.
• DIEP flap reconstruction: This spares the muscle by using skin, fat and blood vessels called deep inferior epigastric perforators harvested from the lower abdomen.

Direct-to-implant reconstruction is a new option that can remove cancer and restore your breast in a single surgery. A saline or silicone implant is placed either in front or behind your pectoralis muscle immediately after your mastectomy is completed. RUSH surgeons are the Chicago area's most experienced with direct-to-implant reconstruction.

Tissue expander and implant reconstruction is the most commonly used option in the country to reconstruct a breast. A tissue expander is part of a staged reconstruction that allows the reconstructive surgeon to start the reconstructing process at the same time as the mastectomy. At RUSH, we most commonly place the expander in the prepectoral or in front of the muscle position, which may lead to quicker recovery, less pain and a more aesthetically pleasing final result. After your breast surgeon removes the breast cancer and surrounding tissue, your reconstructive surgeon will place a tissue expander to stretch the chest skin gradually. After a few months, your surgeon will remove the expander and replace it with a permanent implant. You may want to have your other breast enlarged, lifted or reduced during this second operation to achieve better symmetry.

Combined tissue expander and implant reconstruction with latissimus flap may be the best path for you if you've had radiation or don't have enough breast skin to accommodate a tissue expander. A latissimus flap uses tissue harvested from your back to replace scarred breast tissue and cover the implant.

Reduction lumpectomy and oncoplastic breast reduction is a relatively new option if you're having breast conservation surgery — the removal of the breast cancer and some breast tissue, also known as a lumpectomy — and have large or sagging breasts. Your breast surgeon will remove the cancer, and will work with your reconstructive surgeon to perform a breast reduction or lift during the same surgery.

How Breast Reconstruction Revision Works

Your surgeon will talk to you about your situation and customize a treatment plan. Depending on the issues you’re having, your surgeon might recommend replacing your implants, or reshaping the breast by harvesting fat from another part of your body via liposuction and injecting it into the breast. A breast lift, or a breast augmentation or breast reduction to adjust breast size could also be part of your plan. Whatever the approach, your surgeon’s goal will be to create breasts that look and feel natural and symmetrical.

How Long Does it Take to Recover From Breast Reconstruction Revision?

Your recovery time will depend on the procedure(s) you have — and as with every surgery, recovery is highly individual. During your consultation, your doctor will talk with you about what to expect.

RUSH Excellence in Breast Reconstruction

• Leaders in surgical innovation: RUSH surgeons are pioneers in implant-based and autologous breast reconstruction, with years of expertise in performing cutting-edge advanced techniques in implant-based and microsurgical tissue-flap procedures, including lymphatic procedures. They're the most experienced team in the Chicago area for prepectoral and direct-to-implant reconstruction with advanced training from the nation's top cancer training fellowships.
• The beautiful, natural look you want: Breast reconstruction is equal parts art and science. The surgeons who do these procedures at Rush are all board-certified and fellowship-trained in plastic and reconstructive surgery, and all are exceptionally skilled at translating your goals into the aesthetic result you envision.
• A care team that puts you at the center: Your reconstructive surgeon is part of your multidisciplinary breast cancer care team — including your breast surgeon and oncologists — who collaborate to create your personalized plan of care. Whether you're having surgery as part of breast cancer treatment or as a preventative measure, understanding your reconstruction options is an essential part of your treatment.
• Convenient care: Because our surgeons work from multiple RUSH locations, you can schedule your pre-procedure appointments and post-procedure follow-up at an office that's convenient for you — and because we're one integrated health system, your experience is seamless.