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Breast Implant Exchange

Before & After Gallery | Patient 4

BEFOREAFTER

Patient Details

Case 4 – Bilateral Breast Revision, Exchange of Saline Implants, Left Crescent Lift

Reason for consulting with OC Breast Surgery specialist
This 59 year-old-patient from Southern California noticed her right breast slowly starting to lose volume. A month later it became more clear that her saline implant had failed. Her right breast was looking more and more deflated by the day. Her previous breast surgery had been in 2001.

Saline implant leaks or ruptures are more easily detected than silicone, which often require an MRI. With a saline leak, the breast deflates relatively quickly. The saline solution inside the rubber shell is absorbed by the body (60% of the body is made of salt water). The surgeon gave her the option of having her left breast deflated so that she didn’t feel uneven. This can be done in the office very comfortably without any anesthesia. She decided to replace both implants since they were more than 20 years old with new saline implants. Her breasts had changed over time and were presenting with more ptosis (sagging) but she did not want a lift. The distance measured between her sternal notch and nipple areolar was 24.5 cm on the right side and 25.5 cm on the left. The surgeon advised a Left Crescent Lift to raise the nipple line and make the breast appear more symmetrical.

Surgical Plan – Bilateral Breast Revision, Exchange of Saline Implants, Left Crescent Lift

Pre-Op Sizing
The patient was happy with her current breast size and would not be changing anything about her breasts if she didn’t have a leak. She wanted to remain as close in size as possible to her current implants. She understood that a larger implant might be needed to fill the skin envelope.

Pre-Op Labs
Mammogram
Blood Test
EKG
All breast surgery patients are required to have a Mammogram or Ultrasound within 1 year of the surgery date. All patients must have a CBC and Basic Metabolic blood test to be cleared for surgery. Patients over the age of 50 must have had an EKG within 1 year of the surgery date.

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Day of Surgery
Bilateral Breast Revision, Exchange of Saline Implants, Left Crescent Lift is done under General Anesthesia. Surgical time is 2 hrs and 15 min.

It is worth noting that this patient had a previous heart condition that was being treated with a pacemaker. Our surgeons and anesthesiologists work closely with other providers to ensure the safety of our patients. This patient had no complications from her surgery.

Skin marks were placed with the patient in the sitting position prior to surgery. In surgery, the breasts were prepped and draped in the sterile fashion. The right capsule was entered and a completely deflated smooth saline “McGhan 300 cc” was removed. Inferior capsulectomy was completed, and a 360 cc sizer tried on the right side. The left side was approached in the same fashion, and an intact smooth saline McGhan 300 cc implant was removed. The inferior capsule was released, and similar sizer was placed. The patient was placed in the sitting position and looked very symmetric in shape and size with a few adjustments of the space.

The sizers were removed. The pockets were irrigated with Triple Antibiotic solution and a 330 cc Allergan Natrelle SCM implant was then placed in the space with the use of Keller Funnel. The skin closed with sutures. A left crescent mastopexy was designed, and the skin was excised. The lateral chest areas had been pre-infused with dilute lidocaine/epinephrine/saline solution, and after 20 minutes, the area was reduced with liposuction. The 250 mL total from both sides was removed. The wounds were cleaned with saline and alcohol and covered with paper tape, gauze, and support bra with a 4-inch ACE bandage.

Post Op
The next morning at her first pre-op appointment, the patient was instructed to follow the Breast Implant Moving Exercises several times a day for the first two to three weeks until the implants settled into position. The Ace bandage was removed and the patient told to continue to wear the support bra. Post op photos taken at 2 weeks. At her one month post-op the patient was doing great and was very happy with her breast revision.