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Breast Implant Exchange

Before & After Gallery | Patient 6

Patient 06 - Double Bubble

before-croppedAFTER (2)

Patient Details

Case 6 – Bilateral Breast Revision with Extensive Capsule Repair and Exchange of Implants

Reason for consulting with OC Breast Surgery specialist
This 30-year-old patient traveled from Phoenix, Arizona to meet with one of the OC Breast Surgery specialists for a breast revision. She had been referred by a previous patient because she was unhappy with the results of a previous breast surgery in 2022 done by a surgeon not affiliated with OC Breast Surgery. Before her initial breast augmentation, she was a 34B/C cup. After surgery she was a 34D cup. She was happy with her volume after the first surgery. She was not happy with the shape of her breasts due to the high profile implants. Her chief complaint was a double bubble that appeared when she flexed her muscles. Upon examination, the surgeon determined that her left areolar complex and her left inframammary fold was lower than her right side. He also noted that her left medial inferior fold was not as round as the right side. The surgeon suggested a left crescent lift to even out the appearance of her breasts, but she opted not to.

Surgical Plan – Bilateral Breast Revision with Exchange of Implants

Pre-Op Sizing
Since this patient was happy with her volume, she did not need to do any pre-op sizing. Her current implant size was 450cc in the right breast and 425cc in her left. Given that she wanted to change from a high profile to a moderate profile, thus creating a different shape for the breast, she was comfortable with a range of implants from 400 cc to 450 cc. She provided photos of her ideal breasts, along with breasts she thought were too big, and those that were too small.

Pre-Op Labs
Mammogram
Blood Test
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.

Day of Surgery – Bilateral Breast Revision with exchange of implants is done under General Anesthesia. Surgery time was 3 hours and 25 minutes.

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Before surgery, skin marks were placed with the patient in the sitting position. In pre-op the surgeon and patient again discussed sizing, and both agreed to go up one size implant to 485 cc on the right and 445 cc on the left to compensate for the difference in her natural breast size. In surgery, after removing her intact Mentor high profile implants, the surgeon performed a superomedial capsulotomy to tighten and reshape the pockets for optimizing implant placement. To further correct the double bubble effect, the capsule was entered near the previously cut edge of pectoralis major muscle and the muscle meticulously dissected from the capsule and overlying tissue. Approximately 2 cm of muscle was excised from medial to lateral and then, the capsule closed. Internal sizers were placed through a Keller Funnel and the patient sat up in surgery to see how the breasts fell naturally. To compensate for the asymmetry in her natural breasts the surgeon placed a 485 cc in the right breast and a 445 cc in the left breast. The surgeon altered the capsule more to obtain more symmetry. The sizers were removed, and the pockets irrigated to place the Natrelle Inspira cohesive silicone smooth, moderate profile implants through a Keller Funnel. The patient was placed into a post-surgical bra and surgical tape placed on the sutures to minimize scars and improve healing.

Post Op:
The next day at her first post-op appointment, the patient was instructed to follow the Breast Implant Moving Exercises several times a day for the first two weeks. At her three month post op the implants had settled into place and were moving well. She was happy to have no more double bubble, a better shape, and more even breasts.