Patient 29 Gallery

Before and after bilateral breast implant revision in a 34 year old woman. She felt like her breasts were larger than she wanted and that her former surgeon did not listen to her wishes. Her previously placed breast implants were shaped and textured, and she not only noticed that her right breast seemed to have a different shape than her left breast, but she was concerned that her implants had been recalled.

Her implant pockets were fine; she did not have capsular contracture. We discussed an in-office breast implant exchange under local anesthesia, which would allow her to participate in breast implant sizing. This is a great option for women who do not need significant internal pocket modification such as a major capsulectomy, which would require our patient to go to sleep under general anesthesia.

She chose breast implant exchange under local anesthesia as her preferred surgical option. After injection of numbing (local anesthetic) into her existing inframammary fold scar, the old implants were removed through this incision and inspected. It was found that her right implant had rotated 90 degrees, accounting for the abnormal shape of her right breast – the wide base of the implant was facing outwards instead of toward the base of the breast.

Intraoperative sizing using a saline-filled sizer allowed the patient to choose her new breast implant size. She chose new lower profile smooth round silicone gel breast implants that were 150 cc smaller than her prior implant size. After washing the breast implant pockets out with an antibacterial solution, the new implants were inserted using a Keller funnel. No drains were required.

She was allowed to shower in 2 days and exercise in 2 weeks. Follow up photos are shown 10 months after surgery. Grateful that she did not need another general anesthetic with its attendant postoperative grogginess and nausea, she was also ecstatic that she got to choose her new implant outcome! This is a wonderful option for women who wish to change their size (upsize a small amount or downsize) or to have their breast implants removed.