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Breast Revision Implant Exchange with Lift

Before & After Gallery | Patient 4

Patient 04 - Unhappy with Previous Surgery

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Patient Details

Case 4 – Breast Revision with Exchange of Implant and Super Breast Lift

Reason for consulting with OC Breast Surgery specialist
This 50 year old patient from Newport Beach, California had two previous breast surgeries with a doctor not associated with OC Breast Surgery and was unhappy with her results. She felt her implants were too large which caused them to “hang down”. She currently had a 450cc silicone implant in one side and a 425 cc silicone implant in the other but she couldn’t remember which side had what. She desired to have smaller and “perkier” breasts.

The surgeon examining her noted that she also had a circumareolar lift which resulted in poor scarring, and low nipple areolar complexes. The distance between her sternal notch and nipple areolar complex was 25 cm on the right side and 26 cm on the left, making her a good candidate for a Super Breast Lift, the OC Breast Surgery signature lift. The difference between a Super Breast Lift and other types of breasts lifts is the triple dermal tightening technique applied in the nipple areolar dermis, lower breast curve dermis, and lower breast fold dermis. The other major difference is that the Super Breast Lift does not require any post-surgical drains which are a portal for bacteria to enter the body thus increasing the risk of infection and capsular contracture. Having no drains is also a huge benefit to the patient because it makes recovery so much easier and convenient.

The patient also had redundant fat in the lateral chest because she had gained approximately 40 pounds over the last four to five years. She wanted to lose the weight but didn’t want to wait to have surgery until she had lost her weight.

Surgical Plan – Breast Revision with Exchange of Implant and Super Breast Lift

Pre-Op Sizing
This patient was very concerned about her implants being too big. She thought she didn’t want any implant larger than 350 cc. Since she wanted smaller implants there was no need for pre-op sizing, but she did submit photos of naked breasts in a neutral position to show her ideal breast size along with breasts she felt were too big and too small.

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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.

Day of Surgery
Breast Revision with Exchange of Implant and Super Breast Lift is done under General Anesthesia. Surgical time was 4 hrs and 45 min.

Skin marks were placed with the patient in the sitting and standing positions prior to surgery. The surgeon reviewed the photos she submitted of her desired breast size and he explained that if she lost significant weight in the future, it could make her breasts too small, so he had to take that in consideration and she agreed.

In surgery, the right capsule was entered, and a ruptured implant was found that had not been detected on the mammogram or felt by the patient. Gradually and meticulously, the entire ruptured implant was removed. In the back, there was a little red circle that said Allergan SRF “415 cc”. After the pocket was wiped clean, a superomedial capsulotomy was performed, and ball cautery tightening of the inferolateral capsule was done. Same thing was carried on the opposite side without deviation, but an intact smooth gel SRF 450 cc implant was found. Superomedial capsule was opened, and the inferolateral was tightened with ball cautery.

Various sizers were tried with the patient in the sitting position, and the proposed Super Breast lift incisions approximated with staples and elected to use a 240 cc implant on each side. The Super Breast Lift was performed by tightening and lifting the internal dermal tissues of the nipple areolar dermis, lower breast curve dermis, and lower breast fold dermis. The incisions were sutured and the patient again placed in the sitting position to check the size and shape of the breasts. The patient was placed in the sitting position and looked very good in shape and size. The sizers were removed, the pockets irrigated with Triple Antibiotic solution and the Natrelle 240 cc SRF implants placed on each space and the capsule closed. Skin was then closed with sutures.

The lateral chest and lateral breasts were infused with dilute lidocaine/epinephrine/saline solution, and then after 20 minutes, reduced with liposuction. Approximately 175 mL was removed from each area. The wounds were cleaned with saline and alcohol and covered with paper tape, gauze, and a support bra.

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. She continued to wear a SheFit bra for support. At her one month post op visit when her photos were taken, the patient was healing very well and was extremely happy with the results of her surgery.