MUSC Advanced Breast Reconstruction program

Complications

There are risks associated with all surgeries. All patients must undergo a complete medical evaluation prior to surgery to identify any potential problems. It is important to note that most complications extend the recovery period but do not affect your final results.

Infection

In order to reduce the chances of post-operative infections, antibiotics are given during and after surgery. Most infections are mild and resolve without incident. If a serious infection develops, hospitalization with intravenous antibiotics and possible surgery may be required.

Loss of Sensation to the Skin

Nerves that supply skin sensation will be cut or damaged during surgery. In most instances, the nerves slowly recover over a period of one to two years.

Flap Loss/Total Flap Failure

Reasons for flap failure include:

  • inadequate flap blood vessel anatomy (due to prior surgery or inherent anatomy)
  • inadequate recipient vessels in the chest (due to prior surgery, inherent, or radiation)
  • a blood clot
  • a small kink in the vessels due to positioning of the flap
  • injury to the flap blood vessels at the time of surgery


Fat Necrosis

Fat necrosis occurs when the blood supply in that region of the flap is not strong enough to keep the tissue healthy. As a result, small areas of the reconstructed breast can become firm, and you may develop contour irregularities in your breast. While fat necrosis does not inhibit you from completing your normal activities, it may be bothersome to you and can be fixed with an additional surgery.

Mammographic Changes

Approximately six months after completing your breast reconstruction, you will need to have an MRI (magnetic resonance imaging test). This MRI will allow your physicians to have “baseline” films of your new breasts in order to allow them to more accurately track changes in your breasts in the future.

Scars

Many patients believe that plastic surgeons can perform surgery with little to no scarring. While we have techniques that help minimize scarring, you still will have evidence of surgical incisions.  Most scar formation is determined by your genetic predisposition to scarring. Your own history of scarring will give you an indication of what types of scars you can expect. Steroid injections, silicone-based creams and silicone sheets may be needed to reduce the appearance of scars. Occasionally further surgery is necessary to correct unsightly scarring. Scars take at least a year to become fully matured.

Incomplete Resolution of Lymphedema Following Lymph Node Transfer

Vascularized lymph node transfer is a fairly new technique that is associated with an improvement in lymphedema symptoms in many surgical patients including decreased circumference of the arm or leg, and decreased tightness or heaviness. But a complete “cure” of lymphedema is uncommon.

Systemic Complications

As with any other surgical procedure, you may experience an unexpected medical emergency related to your underlying medical condition such as a heart attack, stroke, heart rhythm problem, pneumonia, or kidney problem.  If severe enough, these problems could result in death.

Deep Vein Thrombosis (DVT), Pulmonary Embolus, Fat Pulmonary Embolus

Blood clots can form during or shortly after any surgery. A blood clot that develops in your leg is called a deep vein thrombosis (DVT). If it dislodges, it can migrate to your lung and is called a pulmonary embolus (PE). A PE typically makes you feel short of breath, and you may experience chest pain and a quickened heart rate. It also can lead to death. We have several standards in place such as SCD boots and anticoagulation therapies in order to minimize the potential for developing these complications. If fat is inadvertently injected into a vein during fat grafting, it can travel to the lung, and if large enough, this event could be fatal.

Seroma and Hematoma

Seromas (fluid collection) and hematomas (blood collections) may form. While your body can reabsorb small amounts of fluid, it may not be able to reabsorb it all. Larger fluid collections may require needle aspiration, or even a surgical drainage procedure.

Skin Infections

Skin infections present as redness, tenderness and swelling. In addition, some patients experience fevers and drainage. Simple wound infections can be treated with antibiotics while a more serious abscess may require surgical drainage.

Capsular Contracture

The body’s natural response to a foreign object, such as a breast implant, is to form a lining or “capsule” around it. Sometimes this capsule tightens and squeezes the implant causing pain and distorting the aesthetic appearance (capsular contracture). This can happen at any time after surgery but usually happens within the first few months. The cause of capsular contracture is unknown. The correction of capsular contracture might require the surgical removal/release of the capsule, or the removal/possible replacement of the breast implant.

Wound Healing Problems

Often your wounds are closed under a lot of tension. As a result, sometimes incisions open. While this will delay your recovery process, it will not affect your final result. Most of the time, these wounds will heal on their own with proper wound care and do not require additional surgery. You may need to be taught wound care techniques, such as wet-to-dry dressings, or need the use of negative pressure therapy (wound VAC). You also may need the aid of a home health care nurse.

No Guarantee of Bra Cup Size

Depending upon where you shop, the type of bra you prefer and how you wear your bra, your bra cup size may vary.  Due to these differences, we are unable to guarantee an exact bra cup size after your reconstruction.

 
 
 

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