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Flap Revision Surgery

Last updated on April 30, 2026 | Reviewed by Ryan Dickey, M.D. on March 11, 2026

These procedures refine breast contour after natural tissue reconstruction.

Summary

Most breast reconstruction takes place over multiple procedures. Even after an immediate natural tissue flap reconstruction, revision procedures can improve breast contour, volume, symmetry, and donor site appearance. Flap revision surgery can take place at any point after the reconstructed breast has healed, and your surgeon will help to plan the safest timing. It is frequently coordinated with nipple areola reconstruction.

Types of Flap Revision Surgery Procedures

Fat Grafting

Fat grafting increases flap volume by moving fat from another area of the body to the reconstructed breast. It can also be used to improve contour by filling indentations or cavities. Fat for grafting is typically harvested through liposuction from the abdomen or thigh regions.

Liposuction

This procedure removes excess fat from a breast reconstruction that is too large.

Nipple Areola Reconstruction

If the nipple was removed during mastectomy, a nipple reconstruction can be performed using adjacent tissue from the center of the breast. This can allow for projection of the nipple papilla. Nipple reconstruction can be combined with nipple tattoo for coloration at a later date, or a 3D nipple tattoo can be performed without surgical nipple reconstruction.

Implant Placement

In some cases, a breast implant can improve the size and shape of a natural tissue reconstruction.

Scar or ‘Dog Ear’ Removal

If the breast or donor site incision develops an abnormal widened or thickened appearance, this can be revised. A standing cone deformity or ‘dog ear’ at the sides of the incision can also be removed if present.

Lump Excision

Issues with blood supply can cause fat necrosis in a reconstructed breast, which results in lumps. These lumps can be removed in a secondary procedure. Radiation therapy increases the risk of fat necrosis. These lumps are not harmful, but can cause discomfort for patients and can be removed.

Abdominal Bulge or Hernia Repair

This highly specified type of abdominal wall repair addresses abdominal wall bulges associated with abdominal flaps. It is not a typical hernia repair. It requires a specific technique.

Procedure details:

  • Revision procedures can take place at any time after initial breast reconstruction has healed, even years later
  • Most procedures are performed on an outpatient basis
  • A plastic surgeon can help you determine which procedure is right for you
  • In many cases, nipple areola reconstruction can be coordinated with flap revision surgery
  • Treatments like radiation and chemotherapy impact procedure timing

Risks & Benefits

Flap revision surgery typically carries minimal risk. Specific risks are dictated by the type of revision surgery performed. Revision procedures take place after initial breast reconstruction has fully healed, usually on an outpatient basis.

These procedures are generally well tolerated with an easy recovery period. They can help patients achieve the best possible breast and donor site contour.

Implant Reconstruction
Natural Tissue Reconstruction
Lumpectomy and Oncoplastic Surgery
Secondary Procedures & Revision Surgery
Mastectomy and Genetic Mutations
Recovery and Risks