Before and after bilateral breast implant revision in a 37 year old woman. She had a toddler at home and wanted to minimize her postoperative recovery. She had had partially submuscular implants for over 10 years. She came to see us to see if we could offer her a simple procedure to help things look and feel better. Her implants felt tight in their space and she disliked the look of her cleavage.
Not all breast revisions require general anesthesia. Her awake, office-based breast revision involved removing and replacing her implants with subtly smaller smooth round silicone gel implants that better fit the implant space (the “pocket”).
Surgical markings are shown in the first image. The bottom of the pocket in her cleavage area was opened up to allow the implant to have a more round shape – this is called a “capsulotomy”. Despite our practice’s preference for subglandular implant placement (on top of the muscle), since she had minimal animation with pectoralis major muscle flexion, we kept the implants in their under-the-muscle pocket.
She participated in her own breast implant sizing by sitting up and seeing what different volumes looked like in the pocket as we changed the volume of the temporary implant sizer. Together we chose an implant that was 70 cc smaller than her original implant size on each side. After the numbing injection (done while our patients breathe a 50-50 mixture of nitrous oxide (laughing gas) and oxygen, she realized that nothing during this procedure would hurt and she expressed that this “choose your own implant experience” was actually rewarding and empowering!
Follow up photos are shown one month after surgery. She is thrilled to learn that her new implants are covered by a 20-year warranty and that she does not need to have another surgery unless she has a problem or wants a different look.
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
