Before and after bilateral breast augmentation revision in a 51 year old woman. Her old silicone breast implants had developed capsular contracture with discomfort and asymmetry. The breast implants lay too low on her chest, in a non-anatomic position – likely contributing to her rib discomfort due to pressure on this area. Her goal was to have more natural appearing breasts and no discomfort.
Her old breast implants were removed and the breast pockets were opened up with a capsulectomy that increased room for the implant higher up on her chest. A sample of scar tissue was sent for culture; fortunately, no bacteria were detected.
The most common bacteria detected in the capsule if there is capsular contracture are Staphylococcus epidermidis from the skin, or Propionibacterium acnes (the acne bacteria!). Unfortunately, both of these microorganisms are known as “commensal organisms” (they live among us) and cannot be completely eradicated. If bacteria are detected on culture of the breast implant capsule, we generally treat with antibiotics for two weeks, institute aggressive implant massage and very close follow-up.
New smooth round silicone gel breast implants were placed higher up on the chest. The folds under her breasts were reconstructed using a suture technique with very slowly absorbing sutures. Follow up photos are shown 6 months after surgery. Her breasts look much more natural, and her discomfort is gone!
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
