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Breast Revision Implant Exchange with Lift

Before & After Gallery | Patient 6

Patient 06 - Breasts That Changed Over Time


Patient Details

Case 6 – Bilateral Breast Revision with Exchange of Implants to Silicone Gel and Super Breast Lift

Reason for consulting with an OC Breast Surgery specialist
This 60 year-old patient from Newport Beach, California had a previous breast augmentation surgery with saline implants in 1998 with one of our OC Breast Surgery specialists. She was very happy with the way her breasts looked over the past twenty-five years, but noticed that her right breast was losing volume and suspected a leak. An implant rupture, whether it’s saline or silicone is not not a medical emergency, but it can be very disconcerting and most patients want to get in to see a surgeon right away to fix it.

When a saline implant leaks or ruptures there are several choices for correcting the problem. One is to replace the defective implant and leave the other one alone. The pluses to this approach is that it is the most cost effective. The minus, especially with 25 year old implants is you don’t know when the other one might fail. Most often patients will choose to replace both implants. Then it is a question of whether or not they are happy with their current breast appearance. Patients may want smaller implants or maybe the same size but their breasts are not as perkier as they once were.

There is one other option for correcting a deflated implant that is the most immediate – deflate the other implant to even out the volume of the breasts. This can be done in the office without any anesthesia. Some patients choose this option because they don’t have the time or resources for surgery. Others do it as a temporary fix until they can get in for surgery.

This patient was eager to correct the appearance of her breasts as soon as possible. She also wanted to address the changes in her breasts over time which were not as youthful looking as they once were. The distance from her sternal notch to her nipple areolar complex was 24.5 on the right side and 27 on the left side making her a great candidate for a full lift, especially since she wanted to also decrease the size of her breasts. The surgeon also talked about implant choice with her and she opted to replace her saline implants with silicone.

Surgical Plan – Bilateral Breast Revision with Exchange of Implants to Silicone Gel and Super Breast Lift

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Pre-Op Sizing
No pre-op sizing was necessary since the patient wanted smaller implants. She wanted to reduce her breasts from a 36DDD to a 36DD or 36D. She provided photos of her ideal breast size along with photos of breasts that were too big and too small.

Day of Surgery
Bilateral Breast Revision with Exchange of Implants to Silicone Gel and Super Breast Lift is done under General Anesthesia in our outpatient surgery center. Surgical time was 4 hrs and 30 min.

Prior to surgery, skin marks were placed with the patient in the sitting position. These serve as the surgeon’s roadmap in surgery. They depict the proposed incisions for the Super Breast Lift. Adjustments are made in surgery if needed.

In surgery, the surgeon entered the right capsule and removed a deflated McGhan 360cc saline implant. The capsule was tightened with ball cautery and sutures. The left side was approached in the same manner and an intact McGhan 360cc saline implant was removed. Various sizers were tried with the patient in the sitting position throughout the case, and eventually the surgeon elected to use a 240cc sizer. He reduced the size of her breasts by removing 65g of tissue from the right side and 85g of tissue from the left.

The proposed lift incisions were incised and the triple dermal tightening technique applied in the nipple areolar dermis, lower breast curve dermis, and lower breast fold dermis. The triple dermal tightening technique is what differentiates the Super Breast Lift from other lifts. It offers more internal support of breast tissues for a better breast shape that holds over time.

Before final suturing and closing the breast, the sizers were removed and replaced with 240 cc Natrelle Inspira silicone SCM implants. The patient was placed in a support bra and skin tape placed on her incisions.

Post Op
The next morning at her first post-op appointment, the patient was instructed to follow the Breast Implant Moving Exercises several times a day for two weeks as the implants settled into place. Photos were taken 11 weeks post-op. Scars continue to improve for one year after surgery.