Before and after bilateral breast implant removal and mastopexy (breast lift) in a 56-year-old woman with 31-year-old saline breast implants. She had developed capsular contracture, pain and asymmetry. After menopause, she had gained a little weight and no longer felt she needed the additional volume her breast implants had provided. Her scars around the undersurface of her areolas were indented and her breasts hung low and looked matronly.
Her breast revision included removal of the old breast implants and their capsule, which had calcified due to chronic inflammation and breakdown of her “second generation” saline breast implants (we now are implanting sixth, seventh and eighth generation implants). In this case, the implant was intact but the body did not like the older implant shell as seen by the chronic inflammation.
Calcified breast implant capsules are often seen in old silicone gel breast implants where the shell has broken down over time. This type of breast implant failure is called implant “rupture”, but this term is actually a misnomer since the implant does not in fact explode; instead the silicone gel usually remains inside the capsule and creates inflammation, leading to formation of additional scar tissue (capsular contracture). The last image in this set shows the inflamed capsule that was completely excised in this surgery.
The old implant space was filled with the patient’s own breast tissue, known as an “auto-augmentation” or breast lift, where the breast is reshaped to a perkier shape that is higher up on the chest wall. Early follow up photos are shown 7 weeks after surgery. Her animation deformity due to the submuscular position of her implants is gone, her swelling is going down and she is ready to start scar therapy.
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
