Case #1415 · Encino, CA
Breast Reconstruction Revision
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This 52-year-old patient from Encino, CA had 3 previous revision surgeries and suffered with breast implant illness symptoms and capsular contracture for years. Dr. Cassileth performed bilateral removal and replacement of her breast implants with ADM
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
Bilateral HBOT protocol, 10–15 sessions over the first 6 weeks.
Bilateral procedures heal more reliably with sustained HBOT.
- Aftercare
Active scar treatment delayed by 2 weeks to give revised tissue more time to settle.
Revised tissue tolerates active treatment less well than primary cases.
- Skincare
Extended scar protocol (silicone + paper-tape compression) runs through month 3.
Revised scars respond best to sustained, layered pressure therapy.
Why this approach
The decisions that shaped this surgical plan.
- Revision case, prior tissue patterns, scar locations, and anatomical changes from the first procedure all factored into the surgical plan.
- Bilateral approach chosen to keep the planning, the tissue response, and the aesthetic outcome consistent between sides.
Pre-op preparation
What to do before surgery. Specific to this case.
- Stop NSAIDs, aspirin, and high-dose fish oil two weeks before surgery; the surgical team provides a full medication list at the pre-op visit.
- 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.
- Arrange button-front or zip-front tops for the first three weeks, overhead reaching is restricted. A drain holder or apron is provided.
- A driver is required the day of surgery and a responsible adult should stay with you the first 24 hours.
Recovery timeline
Milestones specific to this case. Individual recovery varies.
- Day 1–7
Both sides healing in parallel means the early phase is quieter, short walks, full rest periods, and no driving until off pain medication.
- Week 2
Patients off prescription pain medication, walking 1–2 miles daily, and back to most light household activity.
- Week 4
Most patients back to gym cardio at 50 percent intensity. Scar massage protocol begins. Driving restored if not already.
- Week 6
Standard clearance milestone. Patients return to most exercise, gym work, and sleeping in any position.
- Month 3
Most patients consider this the "final result emerges" milestone. The remaining 10 percent of refinement plays out through month 6.
- Month 6
Final shape continues to settle. Revised areas commonly look their best between months 9 and 12.
