Patient 32 Gallery

Before and after breast revision in a 70 year old woman.  Her previously placed right breast implant had deflated several times over the years.  Her left breast implant was fine and she wished to leave it alone, minimizing surgery and trauma to her body.  

She reported that her right implant had previous capsular contracture, which was likely the cause of the saline breast implant deflation.  When scar tissue contracts around an implant, a fold in the implant shell can form and a “fold flaw” can develop and wear on the implant, gradually over time creating a tiny break in the shell allowing saline to leak from the implant.  

Saline is permeable in the body and will naturally be reabsorbed over time, without symptoms or any harm to the body – with the exception of breast asymmetry and loss of volume on the deflated side.  Silicone gel, by contrast, is not permeable in the body and will not be absorbed or travel outside the implant pocket should a silicone gel implant shell break down.

Following breakdown (called “rupture” – this term is inaccurate since the implant doesn’t explode!)  of silicone breast implants, the gel tends to stay inside the capsule – known as “intracapsular rupture”.  This can be asymptomatic or can stimulate scar tissue formation in some cases, causing capsular contracture, particularly with older generation breast implants.  To learn more about capsular contracture, visit this blog post.  

“Silent” silicone breast implant rupture is by definition asymptomatic (with no signs or symptoms), and often does not cause contracture.  The best way to determine whether an older silicone implant is intact is an MRI. Learn more about silicone gel implant safety and monitoring here.  

Since the left breast implant was still soft and felt natural without any concern, only the right breast was addressed.  The deflated saline breast implant shell was removed and a new silicone gel breast implant was placed on the right. Since there was a good amount of breast tissue covering each implant, there was no significant difference between the two breasts in their softness or shape, despite two different types of implants.  

A silicone gel device was chosen because the patient wanted to avoid further surgery (should the saline implant break down).  For the reasons described above, should the silicone gel implant break down at any time in the patient’s future, there would be no asymmetry or symptoms, and she could avoid further surgery.   

Follow up photos are shown 3 weeks after surgery.  She is about to resume exercise and is very pleased with her “final breast surgery”, at age 70!