Before and after bilateral breast revision in a 47-year-old woman. Her naturally tubular breasts (worse on the right than the left) had previously undergone submuscular breast augmentation, but the tubular shape and high fold was not addressed. She consequently had a massive animation deformity and double bubble on the right – which is the old breast fold that is sitting on top of a submuscular implant.
Her original surgeon “did not know what happened,” so she sought other opinions. It was clear to us that conversion of her under-the-muscle implants needed to be converted to on top of the muscle, which would create a smoother transition of the breast over the implant and help to conceal the old inframammary fold. This is the usual treatment of tubular breasts.
Her revision involved removal of the submuscular implants and replacement of her pectoralis major muscles to the chest wall, reconstructing her normal anatomy and resuturing her muscles to the ribs and sternum. A new pocket was created on top of the muscle, in the subglandular position.
New smooth round silicone gel breast implants were placed in this new pocket. A left periareolar mastopexy created improved symmetry to the nipple and areola position. Follow up photos are shown a year and a half after surgery, with greatly improved symmetry.
Her left areola is still waking up but is not fully constricting, which is a normal part of postoperative recovery. With time, the left areola will continue to fully wake up and crinkle with touch or cold, further improving her overall appearance.
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
