Case-10521 Gallery

Before and after breast revision in a 32 year old woman.   She had a previous breast augmentation and always felt she was too big and out of proportion to her petite, fit frame.  She had considered removing her implants altogether but she didn’t want to go back to how flat she felt before her augmentation over 10 years ago.

Multiple discussions with the patient came up with the best solution:  to downsize her implants to a volume and size that felt more proportional to her body.  Thankfully, since we were going down in volume, her pocket around the implant did not need modification and a straightforward implant exchange was the plan.

Implant exchange to a different size can be done in the office under local anesthesia, with patients awake in the office*.  This exciting option allows women to participate in the sizing process and to see what different implant sizes look like in their own body!  For standard breast augmentations, intraoperative sizing is done with the patient asleep.  “Wish pictures” are used and extensive preoperative discussions allow us to carefully select the very best implant for patients.

In this case, someone else (not her!) chose a size that she was never happy with.  So she was thrilled to choose her own implant size!  The old scar under her breast was numbed and excised.  The old implants were removed and a temporary sizer inserted.  Together, we filled the sizer to different volumes and she was allowed to see what size looked best in HER body, with the wound tacked shut and standing upright!

She chose an implant around 100 cc smaller than her old implants.  For her, that made a subtle bur significant difference.  She took a week off work and returned to exercise without restrictions in 10 days.  She now feels much more comfortable and feels her breasts fit her body better.  She is so happy with her results and although the process of choosing her own implant size was daunting, she actually had fun doing it!

*Choosing your own implant size while you are awake in the office is only possible for implant exchange procedures where a pocket is already present in the breast (past breast augmentation), where the location of the pocket does not need to be changed (i.e. not converting from submuscular to subglandular) and for patients who feel comfortable being awake during surgery.