Revisional breast reconstruction after irradiation can be extremely challenging. The major difference between revising an irradiated and non-irradiated breast reconstruction relate to issues of wound healing. In general terms, addition of a breast implant to any reconstruction that involves prior radiation treatment carries increased morbidity compared to tissue-only based reconstructions. Following breast-conserving surgery, extensive local repair can result in major problems with wound dehiscence and sometimes the need for a flap in order to achieve wound closure. Another option of relatively low morbidity for revision of a prior partial mastectomy oncoplasty repair involves use of extensive percutaneous needle release of scar tissue within the breast resulting from the effects of radiation and primary surgery. Deformities in irradiated breasts containing residual native breast tissue relates to scarring throughout the breast consequent to fibrosis from whole breast irradiation as standard treatment.