Breast Reconstruction Complications

That depends on what you mean by “not healing quickly.” If you have an unhealed wound, then something is really wrong, and you should see your surgeon. If it simply hurts or “doesn’t feel right,” then it may improve with time, or you may be developing capsular contracture (a common problem with implants), which may not go away. If you still want a flap, you may well still be able to have one from your buttock or elsewhere.

Richard M. Kline Jr., M.D.

Implants are not actually “rejected” in the medical sense, but some people tolerate them poorly due to complications, the most common being capsular contracture, or heavy, sometimes painful, internal scarring around the implant. It is strange, but true, that no one really understands what causes capsular contracture, or knows precisely how to prevent it. While the exact same implants used for breast reconstruction are also used to augment healthy breasts, contracture may be more of a problem after reconstruction, due to the paucity of normal tissue around the implant (relative to a normal breast). Additionally, radiation seems to sometimes make contracture worse.



Infection will be almost invariably be accompanied by pain, redness, and, if it progresses sufficiently, fever and possibly spontaneous drainage. If your implant is infected, your symptoms will progress rapidly over a period of a few days, and you should seek help at once if you suspect it.

Richard M. Kline Jr., M.D.

In our experience, no, although in a large enough series it may. We have always been able to use the internal mammary vessels, supplied through collaterals, to successfully supply blood to a second flap after an initial flap failed. Generally speaking, the collateral supply to the internal mammary from one intercostal artery is probably sufficient to supply a new flap. I do think that it is advisable, however, to wait at least 3 months following an initial flap failure before attempting a second flap, as this gives time for tissue edema to resolve, and serum protein levels to return to normal.

Richard M. Kline Jr., M.D.