Case #1395 · Torrance, CA
Breast Reconstruction Revision
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This 68-year-old patient from Torrance, CA had a previous right breast TRAM flap reconstruction. Visited Dr. Cassileth because she was unhappy with her asymmetrical breasts. Dr. Cassileth performed a right breast reduction with nipple/areola reconstruction.
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
- Aftercare
Activity progression coordinated with PT, formal check-in scheduled for week 4.
Older patients benefit from a guided return-to-activity plan.
Why this approach
The decisions that shaped this surgical plan.
- 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.
- Aspirin, ibuprofen, vitamin E, and fish oil discontinued 14 days pre-op to reduce bruising risk. Acetaminophen is allowed.
- 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.
- Front-closing clothing only for 3 weeks. Drain holders and supportive surgical bras are issued at discharge.
- Confirm a driver for surgery day and a companion who can stay through the first night.
- Internal medicine sign-off, and cardiac workup when indicated, completes a few weeks before the surgical date.
Recovery timeline
Milestones specific to this case. Individual recovery varies.
- Day 1–7
Short walks every couple of hours, no lifting over 5 lb, and full nights of rest. The worst of the swelling peaks around day 3.
- Week 2
Activity ramps up cautiously: longer walks, no lifting yet. Most patients return to desk work this week.
- Week 4
Mobility ramp slowed deliberately. Physical therapy consultation at the end of this week to plan the next four.
- Week 6
The "back to normal" week for most patients. Final compression schedule transitions to optional.
- Month 3
Most patients consider this the "final result emerges" milestone. The remaining 10 percent of refinement plays out through month 6.
