What is the percentage of people who need a second surgery after reconstruction?

I wonder how many people have problems that require additional surgery.

Expert Answers

drchrysopoulo (Physician - Surgery - Plastic (Verified) ) - 10 / 27 / 2011

Breast reconstruction is the same as any surgery - complications can happen and some of them unfortunately lead to more surgery.

Most specialist breast reconstruction centers have flap success rates of 99%. Implant reconstruction does have a significant re-operation rate long term (within 10 yrs) because of implant related complications such as hardening (capsular contracture), particularly if radiation was used as part of the breast cancer treatment.

It is important to know that most breast reconstruction patients routinely undergo more than one surgery, but not because of complications. The vast majority of our breast reconstruction patients undergo more than 1 stage regardless of the type of reconstruction performed. That is a standard approach for most breast reconstruction surgeons these days....

In the case of a flap reconstruction, the second surgery ("revision stage") typically involves optimizing breast symmetry, nipple reconstruction, scar revision, and contouring of the donor site. A small handful of patients that have nipple-sparing mastectomy and immediate flap reconstruction will not need a second surgery.

In the case of implant reconstruction, most are still performed in stages. The first stage involves placement of a tissue expander and the second stage involves exchanging the expander for a permanent implant. Nipple reconstruction is performed as a third stage. Again, patients undergoing nipple-sparing mastectomy may not need a second surgery but only if they are candidates for the single-stage implant reconstruction ("Alloderm one-step").

I hope that info helps.

Dr C
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