Referred with pain after an implant reconstruction

A number of patients come to the practice after reconstruction somewhere else, referred because something has gone wrong. This patient had bilateral mastectomies with radiation on the right, and implant-based reconstruction. She developed constant pressure and pain on the radiated side and wanted her capsular contracture (tightening of the scar tissue around the implant) corrected.

In this situation the reliable answer is usually to convert to the patient’s own tissue. Radiated skin and an implant are a difficult combination, and replacing the implant with another one tends to repeat the problem.

She had enough abdominal tissue for bilateral DIEP flaps. The first operation removed the implants, took out the capsules and reconstructed with the flaps in the same sitting. A second operation followed to refine the cosmetic result.