Revision breast reconstruction with autologous tissue following failed immediate implant-based reconstruction

Objective. To analyze the outcomes of redo breast reconstruction using autologous flaps in patients with unsatisfactory results after previous implant-based reconstruction. Material and methods. Between September 2020 and March 2025, we retrospectively analyzed 40 patients who underwent redo breast reconstruction with autologous flaps. All patients were divided into two groups: group 1 (n=19) — previous implant-based reconstruction and subsequent redo reconstruction with thoracodorsal (latissimus dorsi) flap; group 2 (n=21) — obese patients with excess subcutaneous fat in the lower abdominal region and large contralateral breast after primary implant-based reconstruction and clear indications for redo reconstruction using a DIEP flap. Results. Mean follow-up period was 37±1.8 months (range 3—57), age of patients — 49.3±7.8 years, body mass index — 26.1±3.4 kg/m². Comorbidities were observed in 37.5% (n=15) of patients. Mean duration of redo reconstruction with autologous tissue was 7.9±1.1 hours, mean hospital-stay — 7.1±2.6 days. No flap loss was observed after redo reconstruction. Mean satisfaction score after autologous flap grafting was 85.2±3.2 (high patient satisfaction). Conclusion. Autologous breast reconstruction is effective after previous implant-based reconstruction with unsatisfactory outcomes. Modern strategies in this field are aimed at reducing donor site morbidity, optimizing recipient vessel preparation, shortening rehabilitation and achieving the most natural aesthetic results.