Before and after bilateral breast reconstruction revision in a 54-year-old woman with congenital chest wall deformity. Over 40 years ago, as a teenager, she had reconstruction of her right breast and chest wall with a silicone gel breast implant and three other mesh implants to try to fill in defects resulting from sunken-in ribs on the right side.
The lower mesh implant had migrated downward and now sat below her right implant, putting pressure on her ribs, and causing pain and an inability to exercise. Both implants were ruptured, as shown on MRI imaging.
Her breast revision surgery involved removal of the implants and their surrounding capsule, leaving the implant and scar tissue intact. This is called an “en bloc capsulectomy” – an extensive procedure that necessitates creation of a long scar under the breast, drains for several weeks and a month-long recovery.
Her previously placed chest wall mesh implants were also removed, as shown in the last set of images. This photo collage documents the intact implants and capsules (opened on the back table to confirm intracapsular implant rupture) and the mesh implants that were also removed.
New smooth round silicone gel breast implants were placed on top of the muscle, in the prepectoral position. She was offered liposuction of her armpit region (axillary rolls), but she wished to minimize trauma to her chest wall.
Follow up photos are shown 5 months after surgery. She is back playing golf, lifting weights and is relieved to know that the most recent breast implants have a 20-year warranty and are much less likely to break down and cause problems. Breast implant technology tends to advance and improve every decade or so, increasing patient safety and lessening the risk of long-term problems.
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
