There are options available if people are unhappy with the results of their breast construction surgery after a mastectomy. These may include waiting for the breasts to settle and heal, using scar creams, using breast prostheses, getting a breast or nipple tattoo, or undergoing corrective surgery.

Corrective surgery aims to alter the appearance and relieve any uncomfortable symptoms from the initial reconstruction surgery.

The American Cancer Society notes that two options after a mastectomy include breast implants and recreating the breast with a person’s own body tissue. This is called flap surgery. A surgeon can take tissue from areas such as the buttocks, thighs, tummy, or back and use it to rebuild the breast.

If people have severe complications from breast reconstruction surgery, they will require immediate medical attention.

This article looks at options for people who are unhappy with their breast reconstruction surgery after a mastectomy.

A tattoo artist tattooing a design on a person who has undergone a mastectomy 1Share on Pinterest
SIMON WOHLFAHRT/AFP via Getty Images. Darryl Veer, owner of a tattoo shop called Tradtoo, works on an artistic tattoo around the mastectomy scars of Jacqueline van Schaik, who got her two breasts removed by surgery in April 2021, as part of breast cancer therapy.

If people are unhappy with the results of their breast reconstruction surgery, options may include:

  • waiting, as the breasts may take a few months to settle or heal after surgery
  • using scar creams to reduce the appearance of scarring
  • using padding or breast prothesis
  • getting a tattoo to cover scars or getting a nipple tattoo
  • getting corrective surgery

Corrective surgery can help to correct original breast reconstruction surgery and may include:

  • a breast lift
  • a breast reduction
  • skin tightening
  • nipple repositioning and reconstruction
  • fat grafting
  • implant replacement
  • pectoral revision
  • scar revision
  • capsulectomy — the removal of the breast implant and a part of, or all of the breast implant capsule

If a person is unhappy with their breast implants or has recurring capsular contracture of the implant after undergoing radiation therapy, flap surgery may be an option. Capsular contracture refers to the formation of hard scar tissue around the implant.

The surgeon can remove the implants and recreate the breast using a person’s own body tissue.

People can speak with their surgeon if they are unhappy with a breast reconstruction. They may be able to provide advice on a person’s available options and next steps. It is important to be honest and tell the surgeon specifically what they are not happy with.

A surgeon may recommend that people wait at least a few months after the initial surgery to see if the breasts change as they heal. Wrinkles, imbalances, and minor distortions may disappear as the breast tissue heals.

After this time, people may wish to seek a second opinion from a different surgeon. Online forums and support groups may have similar experiences and may also be able to advise people.

Once people have considered all the options available to them, they can decide which option is best for them and their circumstances.

If people wish to get a tattoo on their breast or nipple, they can ask for more information from a plastic surgeon’s office or from a qualified tattoo artist.

Once a person finds a tattoo artist, they should ask to see a portfolio of the artist’s previous work, and ask about the sterilization practices the artist uses.

To proceed with corrective surgery, a person can look for a board certified surgeon with extensive experience in corrective breast reconstruction.

People can book an initial consultation and prepare questions to ask the surgeon and ask to see before and after photos.

Corrective surgery may help to treat symptoms such as:

  • appearance of breasts, such as asymmetry or a drooping breast
  • size of the breasts
  • pain from capsular contracture
  • interference with exercise, such as from a subpectoral implant
  • issues like rupture or change in position of implant
  • nipple position
  • noticeable scars
  • loose skin
  • symmastia

Some major issues with implants which people may require corrective surgery for include:

Capsular contracture

One potential complication of getting breast implants is capsular contracture.

It occurs when hard scar tissue forms around the implant. This can put pressure on the implant, making the area feel tight and painful. Capsular contracture can alter the shape of the breast and make it sit higher up in the chest.

The majority of cases typically occur within the first 12 months after getting implants. notes that a person’s chance of developing capsular contracture may be increased if they have previously undergone radiation therapy to treat breast cancer.

A surgeon may replace the implant with a new implant that has a protective layer around it. The body will then form new, less dense, scar tissue around the implant.

Capsular contracture can reoccur. However, it is less likely to reoccur if the surgeon removes the capsule and replaces the implant. A surgeon can also prescribe medications to help prevent the recurrence of the capsular contracture.

Subpectoral implant

A subpectoral implant is an implant under the pectoral chest muscle. This means movement of the chest muscle, such as when exercising, may affect the implant and cause deformity of the breast or the implant to shift out of place.

The American Society of Plastic Surgeons (ASPS) says that a plastic surgeon can change the implant to a prepectoral reconstruction instead. A surgeon places the implant above the pectoral chest muscle. This means any contraction of the chest muscles will not affect the implant.

Changes over time

Over time, people may experience changes or complications with a breast implant.

Breast implants do not usually last for a lifetime, and people may need more than one surgery to alter the look and feel of the breasts, or to treat complications.

Implants may rupture, which can happen if the outer silicone shell develops a tear, or the implant may shift out of the correct position.

Corrective surgery may not help restore a loss of sensation or numbness in the breast.

A mastectomy cuts through nerves in the breast area, which can cause numbness. Over time, it is possible that these nerves may regrow, or people may develop sensation in surrounding areas.

According to the American Society of Plastic Surgeons (ASPS), in some cases it is possible that some sensation may return to the breast over time.

It is important to note that the breasts will still be different to the ones they had before the breast cancer surgery and reconstruction.

People will likely have small asymmetries after reconstruction, particularly if only one breast is removed and reconstructed.

Finally, a person may be able to minimize the scars, but they will never fully disappear.

The risks of corrective surgery are similar to the initial risks of reconstruction surgery and include:

  • anesthetic problems
  • bleeding
  • blood clots
  • fluid buildup in the breast or at donor site with tissue flap
  • swelling
  • pain
  • infection
  • poor wound healing
  • fatigue

Healthcare plans may cover corrective breast reconstruction.

If a health insurance plan covers mastectomies, it must also cover all stages of breast reconstruction on the affected breast, as well as the other breast to provide symmetry. This also includes prostheses and any treatment of complications from a mastectomy.

People will also need to check whether their chosen plastic surgeon accepts insurance. Insurance may not cover travel costs if people have to travel out of their area.

If people are unhappy with breast reconstruction surgery, they can speak with their surgeon. People may want to also get a second opinion, talk with others with similar experiences, and consider all the treatment options.

Corrective surgery may help to alter the appearance of the breasts, but it may not alter sensation. People may want to consider if the potential benefits of corrective surgery outweigh any risks.