Before and after bilateral breast implant revision in a 69 year old woman. Her implants had contracted many years ago from a past dental infection. They sat too high up on her chest because of their placement under the muscle. From the side, you can see why superior malposition of an implant creates what is called the “Snoopy deformity” (the breast is shaped like the Peanuts character Snoopy’s nose) – it is also called the “waterfall deformity”, as the breast is falling off the high-riding implant, like a waterfall.
Capsular contracture is believed to be due to bacteria that can enter the bloodstream following an infection, dental work, colonoscopy etc. and happen to travel to the implant pocket – the body senses that there is something “foreign” around the implant, it mounts an inflammatory response, and scar tissue contacts around the breast implant causing it to feel hard (Baker Grade II capsular contracture), to look distorted (Grade III), or in the worst case, to be painful (Grade IV). (This is why we recommend pre-procedure prophylactic antibiotics before teeth cleanings and other gastrointestinal procedures such as endoscopies or colonoscopies). Soft augmented breasts without any capsular contracture are called Grade I.
This patient’s implants were not painful but they certainly could look better! Her revision involved removing the old saline filled breast implants, replacing her pectoralis major muscles to the chest wall reconstructing her pectoralis muscular anatomy, and placing new larger smooth round silicone gel breast implants on top of the muscle, in the subglandular plane.
Follow up photos are shown one month after surgery. She is very pleased with her more natural looking and fuller breasts.
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
