Patient 37 Gallery

Before and after breast revision in a 31 year old woman. She previously had breast augmentation with silicone gel breast implants but felt they were too large for her frame. She also developed mild capsular contracture, most evident with her hands above her head and from the side.

She disliked the upper pole “top heavy” look and curvature of the upper part of her breast. She wanted to keep implants but to downsize and look more natural, particularly from the side view. An in-office implant exchange was planned. Once a pocket is formed around an implant, implant exchange is straightforward to plan, as long as the pocket does not need modification. In this case, because she wanted to go slightly smaller, a simple implant exchange was very reasonable to do using her existing inframammary fold incision.

The incision was numbed in the office using local anesthesia, and the old implants were removed. A temporary sizer was inserted and was inflated to a variety of volumes slightly less than her original implant size. The incision was closed temporarily and the patient was able to PARTICIPATE IN HER OWN SIZING. She selected an implant slightly smaller than her previous implants and was able to stand up and compare different volumes directly with the other breast.

She chose an implant around 75 cc smaller than her current size. The new implant was inserted using the Keller funnel and after irrigation with antibiotic solution. The wound was closed, and the other breast was then sized independently to ensure she had the very best symmetry. It is common for women to require two different sized breast implants, since no two breasts are exactly symmetric before surgery. In this case, she required two different sized implants at this implant exchange to achieve symmetry. In all, it was an extremely empowering procedure for her and she was thrilled to participate in the sizing!

Follow up photos are shown two weeks after surgery. Other than some incisional discomfort, there was no need for drains and she returned to work in two days. She is ready to begin exercise again and she has indeed achieved her goals of a more natural look!