Before and after bilateral breast revision in a 61-year-old woman with a left deflated saline breast implant. She wanted to avoid major surgery and asked whether a new implant could be put in awake, under local anesthesia. She had heard about our “tip toe” awake implant exchange, and she was a candidate, as she did not need major pocket modification.
Her existing areolar scars were used to access her implant pockets. We often recommend creating a new incision in the fold of the breast, but every surgery involves a discussion with the surgeon and patient playing equally important roles in the shared decision-making process.
After breathing inhaled laughing gas and taking an oral anti-anxiety pill, her old saline implants were removed, and the pocket was inspected. A saline-filled sizer was used to fill the pocket, and the patient was able to help choose her new implant size! She chose to have slightly larger implants inserted; this time filled with silicone.
Once she chose her new implant size (determined by filling the saline sizers to different volumes, just like we do when patients are asleep under general anesthesia), the pocket was washed out with an antibiotic solution. New smooth round silicone gel breast implants were inserted, and her incisions were closed using three layers of dissolving sutures.
She showered 48 hours after surgery and resumed exercise in two weeks. Follow up photos are shown 6 weeks after surgery. She loves her results, and the experience of “choosing her own boobs” was fun for her!
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
