Before and after left breast revision in a 25 year old woman. She had a previous breast augmentation and some years later had developed left capsular contracture that had been stable for over a year. Once capsular contracture develops, the space around the breast implant closes off, and the implant becomes too tight in the smaller space (like an overstuffed pillow). A contracted implant looks too top heavy and unnatural when the arms are raised overhead.
A simple solution that can be done in the office under local anesthesia is to remove the implant and insert a smaller implant that fits the space better (like removing some of the stuffing from an overstuffed pillow). We have nicknamed this procedure the “tip toe procedure”. We don’t want to wake up any additional scar tissue by performing capsulectomy incisions on the inside. After infiltrating local anesthetic, a swap out of implants can be done via the existing incision under the breast.
Just like in the operating room, a temporary sizer is used to help determine which implant volume best matches the other side. In this situation, because the patient is awake, she can sit up and help decide which volume is best for the new implant. It is a little surreal for patients but very empowering that they can decide what result is best for them! This method cannot be done for the original breast augmentation – patients must be asleep in the operating room for creation of a new pocket.
Follow up photos are shown one month after surgery. She has greatly improved symmetry and is grateful she did not need to go back to the operating room for this revision.
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
