Patient 383 Gallery

Before and after bilateral breast implant revision in a 58-year-old woman. Her implants were placed twenty years previously under the muscle. While she did have a mild animation deformity (not shown), it did not bother her.

She had always felt like “she was made too big” and following pregnancies and recent menopause, she felt her breasts looked too large for her frame - but did not know her current implant size. Asymmetry of size had also become evident, with the right breast being larger than the left - most visible with her arms overhead.

She did not want to have a big surgery or downtime. She was thrilled to learn that she could plan an implant exchange awake, under local anesthesia, using the existing scar under her breasts and that she could actually help choose the new implant size and her final results!

Surgery was planned in our operating room under local anesthesia (numbing injections) with inhaled laughing gas and an oral anti-anxiety medication. The old implants were removed to be filled with saline, each weighing 260 grams, which is equivalent to 260 cc or mL. Her implant pocket was left alone, as the under-the-muscle placement was not an issue for her.

A temporary sizer was inserted and filled up to 260 cc with saline so that she could see how her breasts looked with the old implants - then saline was slowly removed from the sizer so that she would “try on different sizes”. She ultimately chose a 215 cc implant for the left breast, and 195 cc for the right larger breast. The slightly different implant volumes helped to even out her breast sizes and achieve better symmetry.

The sizers were removed, and smooth round silicone gel breast implants were placed in the existing implant pockets after washing the pockets out with an antibacterial solution. She did not require drains or any pain medicine afterward. She showered in 48 hours after surgery, and returned to full exercise within two weeks.

Follow up photos are shown 3 weeks after surgery. The results are “subtle, but significant” - mostly to her. She feels less top-heavy and matronly, lighter and refreshed!”