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Before and after revision of the left breast in a 27 year old woman. She had a prior breast augmentation with multiple complications and several subsequent surgeries to attempt to correct it. She was left with severe bottoming out of her left breast implant causing deformity, embarrassment, self-consciousness and pain related to the implant sitting on her left ribs.

Her implants were both under the muscle (seen when the arms are overhead as a tight muscle band in the armpit); she wanted to keep a submuscular implant. She was happy with her right breast and wanted to leave it alone. Correcting bottoming out of a breast implant is challenging, particularly if past attempts have failed. Her revision surgery involved opening up the pocket at the top of the breast via capsulectomy, reconstructing her left inframammary fold using long- lasting strong sutures from the inside fold of her breast to the perichondrium (the firm and stable lining of her rib cartilage lying over the fold). The fold was overcorrected to allow for tissue relaxation and successful fold reconstruction.

Follow up photos are shown three weeks after surgery. Her drain was in place for 10 days. She is still avoiding exercise until she is over a month out from surgery. She has mild swelling of the left breast which is evident mostly in the upper pole. Slight overcorrection of the left breast means that it will look nearly final by three months when the swelling resolves and the breast tissue relaxes.

The bottoming out has been successfully corrected and she is so relieved the years of deformity and pain are now behind her. She understands that the most common complication after this type of breast implant revision surgery is recurrence. She will continue to follow up over the years to ensure stable symmetry.

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*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.

Dr Karen Horton