At least once a week, someone comes to my office, feeling a little awkward about her consultation. She is not happy about her (old) reconstruction, but thinks that she should be happy just to have “breasts.” They are (fortunately) rarely about surgeries originally done by me. However, nobody is perfect and every situation is a little different. (Location of original cancer, thin skin, age at surgery, radiation, etc.–all play a part in results)
Either way, unless there is a serious medical condition that prevents surgery, I believe that every woman deserves breasts that make her happy and proud to face the world.
Our consultations can have various scenarios. They range from “This is about as good as any plastic surgeon can produce and I have nothing better to offer,” to “a little tweaking with fat grafting should help,” to “if you really want breasts that are as nice as they can be, we need to start over.”
Decisions about revisional breast reconstruction surgeries are always a realistic compromise. A patient needs to review what may have changed since her original surgery and is it worth the risk of additional surgery and anesthesia.
Implants have changed significantly in composition and shape in the past ten years. Microsurgery has become more common in that time and fat grafting has become better understood and executed in that time as well. Even the acceptance of an “old school” tattoo artist for nipple pigmentation is now more widespread.
Sufficient to say, you at least owe it to yourself to speak to a plastic surgeon if you are not happy with your reconstructed breasts; the answer may surprise you.
Dr. Alissa M. Shulman is a board-certified plastic surgeon and lifelong artist and sculptor who founded her solo practice, Sovereign Plastic Surgery in Sarasota, FL.