Before and after bilateral breast implant revision in a 48 year old woman. Her old textured breast implants were in the submuscular position, causing them to sit too high up on the chest. She felt her breasts “looked fake” and was looking for a more natural look. She had changed her necklines in order to “always try and hide them”.
Implants that are placed under the muscle often sit high up and widely spaced, as the pectoralis major muscle has a diagonal line of pull (vector) that pulls up and out, toward the shoulder. Every time the muscle flexes, the implant often become flattened and it can migrate upwards and outwards, following the pull of the muscle.
This patient’s revision involved making a new incision in the fold of the breast, removing her old textured implants, replacing the pectoralis major muscle to the chest wall, and inserting smooth round silicone gel breast implants on top of the muscle, in the subglandular position.
She was offered a breast lift (mastopexy) as well, which would tuck some mildly baggy skin at the bottom of the breast, but she did not wish to have an additional “lollipop scar”.
Implants that are converted from under the muscle to on top of the muscle sit in a more natural position on the chest, behind the nipple and breast rather than higher up above the breast. Follow up photos are shown 4 months after surgery.
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
