Revision Breast Augmentation (Individual Result May Vary)

PATIENT 30-RA

   

   

   

This is a 48YO lady from Enterprise, Alabama.  She has had a previous breast augmentation around 20 years ago.  With time, breasts naturally droop which is the effect of gravity and child bearing.  As you can see from her pictures, the nipples are downward pointing and the breasts are quite full superiorly.  She has also has a mild capsule contracture which is scar tissue that forms around a breast implant.  This is causing the breast to have an unnatural appearance due to the implant being too high making the breast appears too low and pointing inferiorly. 

In order to correct this, the capsule must be surgically removed which is a fibrous body reaction to an implant that occurs in some patients.  This allows the implant to drop some and eliminates some of the superior fullness of the breasts.  Then the low breast tissue and nipple will be raised to the appropriate position.  This procedure is called a breast lift or mastopexy.

You can see from the post operative pictures that her breasts now have a nice shape with plenty of superior fullness but no droopiness of the nipple or breast tissue.  The scarring with this procedure is usually minimal.

This procedure is done as an outpatient procedure and patients can usually return to office type work in about 2 days.

PATIENT 29-RA

This is a middle-aged patient that has had breast implants with a mastopexy done about 8 years ago.  She had gained some weight and a great increase in size in her breasts.  She had symptomatology associated with large breasts that included posterior neck pain, headaches on the back of her head, and pain between her shoulder blades.  She also had painful bra straps.  Her pre-op pictures show very large breast implants that have dissected the inframammary crease down onto the abdominal wall.  This is a result often seen when the inframammary crease is disrupted in attempts to put in implants which are too large.  This not only gives the breasts an abnormal shape but also makes the nipple areola appear too high.  The correction was done in stages.  The first stage we did was to remove the large implant which were almost 600cc and then reattach the dissected abdominal wall tissue back onto her abdomen.  This put the breasts back where they belonged on her chest wall and re-established the correct position for the nipple areolar complex in relation to the inframammary crease.  Several months were required to get good adherence of the stretched out skin back to its normal anatomic location.  We then returned to the operating room where implants were replaced.  We put in 345cc on both sides using the new Natrelle, gummy bear implants.  She is quite happy with the results of her surgery, new size, and resolution of her neck, back, and shoulder symptomatology.

PATIENT 28-RA

  

  

  

This is a 32YO lady from Bainbridge, Georgia that desired some cosmetic improvement of her waist and buttocks area.  She has a moderate amount of fat in the flank area.  She has tried dieting but could not get any significant decrease in the waist circumference.  She noticed that her pants seemed to ride high because of the bulging in the love handle area. 

She underwent SAFE liposuction of the love handle area and abdomen with fat grafts to the buttocks.  As you can see, there is marked improvement in the shape of the waist and buttocks.

Fat grafting is where we remove fat from one area, process it, and inject it into an area that needs some more projection.  This helps improve contouring of the body.  Usually, about half of the fat will live permanently.  The fat does not live is reabsorbed by the body.

PATIENT 27-RA

  

  

  

This patient was referred by her gynecologist.  She has breast implants placed in 1991 which were textured gel implants in the submuscular position.  She did well until just prior to presentation here in my office where her breasts had gotten progressively firm and uncomfortable to the point where she actually was seen in the ER.  She had contracted breast implants with ptosis of the breasts off the inferior border of the implants.  She wished to be smaller in that she had some upper back, neck, and posterior head symptomatology related to her breast size as well as the droopiness of the breasts.  She underwent a redo augmentation with mastopexy.  She had some gel bleed on the surface of the implant.  We were able to convert the implants and maintain a new pocket beneath the muscle and replace these with the newer cohesive gel implants.  The mastopexy centered the breast over the newly shaped breast mound.  She has maintained nipple sensation.  She is about a ½ cup size smaller than she was.  The shape of her breasts is more normal and she has maintained more attractive upper pole fullness as shown in her post operative photographs.

PATIENT 26-RA

  

  

  

This is a woman who had 31YO gel implants that had gotten progressively firm and encapsulated. The left sided breast was painful and deformed secondary to the capsular contractures. She had adequate breast tissue to facilitate re-augmentation. The implants were subglandular, on top of the muscle. The MRI confirmed rupture of the left-sided implant. She was carried to the operating room where she underwent removal of the encapsulated implants. This required bilateral capsulectomies, removal of the dense scars around the old implants, and insertion of new implants beneath the muscle. She did not require a lift. She got a beautiful result from the revisional surgery. The breasts are soft and symmetrical. There is no further pain in the breasts. She measured as a full D. She enjoys the normal shape and feel of her newly reconstructed breasts.

PATIENT 25-RA

  

  

  

This is a lady that had saline implants about 10 years ago.  She presented with a recent deflation of the right breast.  Over the intervening years, her breasts began to droop and she had lost some volume in the breasts.  She wished to have them redone with gel implants and a mastopexy.  She underwent augmentation/mastopexy with 310cc silicone gel implants.  We were able to create a new submuscular pocket so that the implants could remain in a submuscular position.  Post operatively, she has maintained nipple sensation and has gained cup size in her bras.  She now has breasts that feel more natural with the silicone implants. 

PATIENT 24-RA

  

  

  

This is a 40ish, white female that had transaxillary saline breast implants placed several years ago.  She developed a C range breast from that procedure.  Over time she was considerably heavier and over the interim she has undergone a gastric sleeve procedure for weight loss.  She lost over 100lbs.  This resulted in breasts that were still large and mobile.  When she would lie down, the breasts would fall laterally off her chest wall.  She wished to be smaller with her breasts back up on her chest.  She wanted something done to keep them from falling off her chest when she lay down.  She underwent an augmentation/mastopexy.  I removed the saline implants and replaced them with smaller gel implants.  The implants she has placed in her post operative photographs are 240cc implants.  She was reinforced with Seri which tightened and diminished the pocket size.  This helps keep the implants up on her chest when she lies flat on her back.  She has maintained nipple sensation.  The breast size and shape is more amenable to her.  Ultimately, we have planned surgeries for the loose skin and stretched out abdominal muscles. 

PATIENT 23-RA

  

  

  

This is a 35YO lady that had a previous breast augmentation with saline implants. These implants deleted on the right side. You can see preoperatively that she has a lot of asymmetry of the breasts. When an implant deflates, you can get scar tissue around the implant and the implant pocket has to be re-expanded. This is what I had to do on her. She is 5 months s/p revision breast augmentation with silicone gel implants. The breasts are now in perfect position and soft.

PATIENT 20-RA

Before n After  PATIENT 20-RA

PATIENT 20-RA  PATIENT 20-RA

PATIENT 20-RA  PATIENT 20-RA

This is a lady that had fallen and injured her right breast. She had developed scar tissue around the right breast and the implant was elevated. The nipples were also pointing downward. She underwent a revision breast augmentation and breast lift. Now the breasts are in good shape. They are soft with the nipples pointing forward as they should be.

PATIENT 19-RA

Before n After  PATIENT 19-RA

PATIENT 19-RA  PATIENT 19-RA

PATIENT 19-RA  PATIENT 19-RA

This is a young lady that had breast implants 11 years ago with saline implants. She went from a B cup to a D cup and then had two pregnancies aftwerwards. The breasts almost from the get go had bottomed out resulting in implants that were too low on the chest wall with loss of upper pole fullness and breast tissue extending down, up, and over her abdominal wall. She was having neck, back, and shoulder pains from the size of her breasts. She wished to have her breasts back up on her chest and a smaller size. She was carried back to the operating room where we replaced her 375cc implants with 300cc implants and then she underwent a revision of the breast capsule with inferior infralateral capsulorraphy. This was reinforced with seri surgical implants to reinforce the repair. Operations to correct capsule deformities are best reinforced with some type of dermal substitution. We have had very good luck with the seri material. She is hown postoperatively with a much improved contour and shape. There is return of the upper pole fullness, sharp creases, and a breast mound that is back up on her chest and off her abdomen. Her preoperative breast size was a DD and now she is large C.

PATIENT 18-RA

Before n After  PATIENT 18-RA

PATIENT 18-RA  PATIENT 18-RA

PATIENT 18-RA  PATIENT 18-RA

This is a 45-year-old lady from Panama City, Florida who has been having problems with her breasts. She has had a previous breast augmentation. She has gotten scar tissue around the implants. This has caused the implant to be elevated. Also, the breasts are quite asymmetrical. The scar tissue that has formed has made the breasts feel firm. It has also displaced the implant superiorly and made the nipple look like it droops over the implant.

We went in and did a revision breast augmentation on her. Now, the implants are in good position and the breasts have a good shape. They are now soft. She now feels much better about herself and is also much more comfortable.