Before and after bilateral breast revision and nipple reduction in a 46-year-old woman. Her old submuscular saline implants sat way too high on the chest due to their totally submuscular placement. Her breast tissue hung off the bottom of the implant, causing a “Snoopy” or “waterfall deformity”.
She asked about a breast lift at the same time as her breast implant revision to lift her nipples. Her nipples sat relatively low on the breast due to the implants sitting up so high – they were rotated downward naturally, like the opposite of slipping on a banana peel. The solution was creation of an implant pocket lower on the chest behind her natural breast footprint, rather than under her collarbones, so that the nipple would be proportionally located.
Her revision included removal of the old saline implants, separation of her pectoralis major muscle from the undersurface of the breast tissue, replacement and reconstruction of the muscle to the chest wall, creation of a new implant pocket on top of the muscle lower and in the subglandular position, and insertion of new smooth round silicone gel breast implants.
A nipple reduction was done at the same time to reduce the length of her nipples and stabilize their floppy base. She had drains in place for a week and took a full month off exercise. Follow up photos are shown one month after surgery.
We disagree with the claim that implants “look more natural if they are under the muscle”. All of her complaints were corrected just by moving her implants to on top of the muscle! This is why we prefer implants on top of the muscle in nearly every situation, even in thin and muscular patients like her.
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
