Plastic Surgeons will tell their breast reconstruction patients that optimal results often require several surgeries. They will even include this fact in the informed consent document that must be signed prior to surgery. Each of these follow-up surgeries is often referred to as a breast revision.

Some women are fortunate to attain acceptable results within a year; others are not so lucky. I put my faith in reconstruction, but after four years of revisions and unremitting pain…I was done! It just did not work out for me, and I chose (what I call) “breast deconstruction.” The medical name is breast explantation.

No one plans that she will become one of the statistics for complications, but it is a reality for far too many. Below are more perspectives on this topic.

Disappointments and Complications

Some of the disappointing imperfections that can occur during the breast reconstruction process (and lead to revision surgeries) include:

  • asymmetry (a difference in the size and shape of the breasts)
  • hollow or concave areas in chest or a sunken cavity
  • shifting of an implant, creating a lopsided look
  • incorrect size of an implant, leading to concave areas or contorted muscles
  • scar tissue contracture that causes pain and indentations
  • “dog ears” that are protrusions of skin or fat, creating an unpleasing visual result.

Complications are a cruel twist in this journey, some of which include:

  • infection, which is one of the major complications that force the decision for revision surgery, taking it from an elective procedure to a life-saving treatment
  • seroma (a fluid-filled lump where tissue has been removed)
  • neuroma (a bundle of nerves in scar tissue that forms a benign lump)
  • capsular contracture (scar tissue creates a tight capsule around an implant that causes pain and hardness)
  • necrosis of a flap that occurs when blood supply is not sufficient enough and results in the transplanted tissue dying
  • lymphedema that occurs when the flow of fluid in the body is impeded after lymph nodes are damaged or removed.

Revisions are a Roadblock to Completion

Elective breast revision is yet another hurdle along the path towards completing our reconstructions. Let’s face it…who wants to undergo another surgery? Even though insurance companies are mandated by law to cover breast revision (read more at Plastic Surgery.org) (since it is a medically-recognized need to achieve optimal reconstruction results), it is sometimes just easier to settle for sub-par results. It is tough to get geared up and risk yet more surgery.

This hesitation creates roadblocks towards completion of our reconstructions, a process that can take years for many women. The need for revisions blocks our way towards full completion of the process because nipple reconstruction and/or areola tattooing cannot be done until all revisions are completed. This is because the size and shape of the breast mound must be finalized before placement of the nipple/areola can accurately be determined. The geography of the mound changes with each revision, so placing a nipple or an areola tattoo would result in them being off-center if a revision were done afterwards.

Temporary Tattoos: A Soothing Solution during the Revision Process

Rub-On Nipples® fill the void for women going through breast reconstruction who are not yet ready for a nipple reconstruction or permanent areola pigmentation procedure. These temporary areola tattoos last one to two weeks and are easily removed with rubbing alcohol. They offer a soothing, temporary solution during this stage.

Some use the temporary tattoos as a permanent solution.  Some women stop short of fully completing the process because they are weary of procedures, leery of the tattoo procedure or just so exhausted from their journey. Rub-On Nipples® offer a simple alternative so that they can experience the joy of this defining visual focus on their mounds.

For more information, view our Rub-On Nipples® topics on the navigation bar.

Accepting Sub-Par Results

Why do so many women stop short and decide to live with sub-par results? We get busy, and we are just tired of procedures. We fear another surgery and are afraid of complications. We do not have the time to take off from work. We are caregivers for other loved ones. There are so many understandable obstacles that block our way.

It helps to encourage each other to move forward in our reconstructions. We deserve optimal results, but it takes determination to stay focused on finishing the process. It is an individual decision that can be gut-wrenching to make.

Failed Reconstruction

The failure of a breast reconstruction happens after multiple surgical revisions and ongoing complications. Usually by the time a reconstruction is considered a failure, the patient is in distress and pain. Read our section on Post-Mastectomy Pain.

When failed reconstruction happens we not only grieve the loss of our reconstructed mound(s); we are then faced with the agonizing decision whether to start from square one and begin the process again.

Women describe going from surgeon to surgeon and researching multiple alternative options. I personally have consulted with seven plastic surgeons through the years, and I am not done yet. This path is filled with detours and winding roads. One of the end results could be choosing breast deconstruction and living the flat life. Read our sections on choosing No Reconstruction and Breast Deconstruction.

Warning: Strong Opinion Here about Breast Reconstruction

A Personal Opinion about Breast Reconstruction

by Elizabeth Vivenzio

Breast reconstruction is sanitized by the medical profession. Don’t get me wrong; it is a wonderful thing to be able to recreate a breast. Unfortunately, it does not always work out as planned.

As the numbers of those with complications after these surgeries climb, there is a growing trend among women who have detoured off that long, arduous road and reached a destination called breast deconstruction.

We strive to provide a platform to address these issues. along with an advocacy blog for those of us (like me) who have chosen or are considering breast deconstruction.

The breast reconstruction process leads to so many different paths. Some are manageable, some are tolerable, and some are downright tortuous. I have been on a mission of mastectomy empowerment since my 2009 surgery, which is when I began publishing educational sites about post-mastectomy issues.

It is important to note that I am thrilled for women who have successful breast reconstructions, and I wholeheartedly support awareness efforts to assure that all women know about their reconstruction options. It is vital, however, that those making these decisions are empowered with the knowledge of the pitfalls…some of which can be avoided by proactive strategies that I discuss through my writings.

There is a glaring need for advocacy to help those who struggle with challenges after these surgeries. The statistics and peer-reviewed studies validate this need. Up to 60 percent of women have pain after mastectomy.

Another strikingly profound source of validation for this advocacy are real-time comments on social media outlets. Women on these sites are crying in pain and sharing stories of complications and dashed hopes and dreams of breast reconstruction.

Living in pain is a very harsh reality of breast reconstruction. The purpose of this effort is to create a voice for those of us living this reality.