Case #1393 · Beverly Hills, California
Breast Reconstruction Revision
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This 54-year-old patient from Beverly Hills, California had a history of breast cancer and underwent a right breast lumpectomy. She was not happy with the divots caused by the lumpectomy and asymmetry of her breasts. Dr. Cassileth performed a bilateral breast augmentation with fa
Continued care
Recommended aftercare, skincare, and MedSpa services for Breast Reconstruction Revision.
- Compression bra continuously for 6 weeks
- Sleep elevated on your back for 2 weeks
- Hyperbaric oxygen therapy when recommended — common in revision and post-radiation tissue
- Scar management at 3 weeks; aggressive protocol for revision sites
- Medical-grade silicone sheeting on revised scar lines
- SkinCeuticals C E Ferulic for scar healing
- SPF 50+ on incisions for 12 months
- Laser or microneedling for revision scar refinement after 3 months
- Indiba radiofrequency for tissue recovery
- LED light therapy weekly for the first 8 weeks
- Coordination
Long-term surveillance imaging stays on the oncology pathway; our team coordinates timing with theirs.
Post-mastectomy patients stay on a long-term surveillance pathway.
- Aftercare
Priority lymphatic drainage starting week 1.
Lymphatic disruption from axillary work makes early drainage more valuable.
Why this approach
The decisions that shaped this surgical plan.
- Approach driven by the oncologic priority first: incisions and tissue handling chosen to give the oncology team the access they need, then to set up the cleanest reconstructive canvas.
- Surgical plan calibrated against the opposite side. Final shape, scar position, and volume targeted to match, not to a generic ideal.
Pre-op preparation
What to do before surgery. Specific to this case.
- Discontinue blood thinners (NSAIDs, aspirin, fish oil, vitamin E) two weeks out. Acetaminophen remains safe; the full list is reviewed at pre-op.
- Nicotine in any form, cigarettes, vapes, patches, gum, paused six weeks before and six weeks after surgery. Nicotine narrows blood vessels and slows wound healing.
- No overhead clothing for 3 weeks. Stock front-zip tops, supportive sports bras (post-clearance), and the drain pouches we provide.
- Confirm a driver for surgery day and a companion who can stay through the first night.
- Pre-op coordination with the oncology team confirms imaging, biopsy results, and any neoadjuvant timing. The surgical team owns this loop.
Recovery timeline
Milestones specific to this case. Individual recovery varies.
- Day 1–7
First week prioritizes drain care, walking short distances, and avoiding any overhead reaching. Multi-modal pain control keeps narcotic use brief.
- Week 2
Walking distance doubles. Showering rules relax. Compression garments transition to the long-wear schedule.
- Week 4
Return to most low-impact activity. Scar massage, compression, and skincare protocols pick up.
- Week 6
Most physical restrictions lift. Return to strength training, full-impact cardio, and overhead lifting.
- Month 3
First major reconstruction assessment. Tissue softens, surveillance imaging if indicated coordinates here.
- Month 6
Final aesthetic emerges. Last-mile adjustments (fat grafting, nipple reconstruction) typically scheduled now.
