A patient unhappy with a breast reconstruction performed elsewhere may arrive disappointed, frustrated, or angry, and she may have lost confidence in reconstruction itself.
Dr. Susana Benitez is chief of plastic surgery at Clínica Las Condes and a plastic surgeon at the University of Chile. She presented ‘Taking over the care of a dissatisfied patient after breast reconstruction’ at Plastic Surgery The Meeting 2026, organized and hosted by the American Society of Plastic Surgeons (ASPS). The meeting was held October 15 to 18, 2026, in Houston, Texas. Her talk was part of the panel ‘The botched breast.’ Setting surgical technique aside, she described how she receives these patients.
Her approach follows a deliberate order: comfort, acknowledge, assess, remain neutral, and only then offer alternatives. ‘We need to establish trust, and sometimes this is more challenging than the reconstruction itself,’ she said. Each consultation begins by listening to what happened, what bothers the patient, and what she hopes for. Comfort, she cautioned, is different from agreeing to every request.
‘Magnitude of deformity and the magnitude of the patient's distress are not necessarily related,’ Dr. Benitez said. A modest asymmetry may deeply trouble one patient, while another tolerates a far worse result. She avoids phrases such as ‘it's not as bad,’ which fail to validate those feelings. She also avoids criticizing prior treatment. Her responsibility, she said, ‘is not to judge the previous surgeon, but to help the patient move forward.’
Another Breast Revision Is Not Always the Answer
Options range from observation, because ‘no operation is also an option,’ to a limited revision for one dominant problem, to staged or completely different reconstruction. For each, she explains benefits, limits, risks, and what may remain imperfect. One long-term study she cited found that patients undergoing 4 or more revisions reported lower breast satisfaction and a worse overall reconstruction experience. Each procedure lowers predictability and the patient's tolerance for another disappointment. ‘This is why I believe revision must be a shared decision,’ she said.
Two Patient Cases Show Prior Reconstruction Failure Need Not Predict the Next Outcome
Her first case was a 70-year-old retired nurse with pain and a chronic, non-healing wound. Her previous surgeon had not felt safe removing her implants, but she wanted them out to retire to southern Chile, near a lake and hot springs. She wanted a functional result. After implant removal, she is happy. ‘I don't think it's such a beautiful result at all, but she's happy with that,’ Dr. Benitez said.
The second, a 42-year-old, lost her tissue expander to infection after mastectomy and radiotherapy. Twelve months later, delayed reconstruction with a deep inferior epigastric perforator flap brought in well-vascularized tissue; the procedure was uneventful, and the patient was very satisfied. ‘Previous reconstruction failure does not necessarily predict another unsuccessful outcome,’ she said.
She closed by returning to her principles, the last of which is to align expectations and agree on a realistic endpoint before any surgery.