This patient had saline implants placed 13 years prior with 375cc filled to 460cc on the right and 475cc on the left. She wanted to be larger but also felt uneven. Her “before “picture shows a cleavage gap, the left breast higher than the right, and a short inframammary fold on the right. One challenge is if the implant is lowered too much on the left, it will push the nipple even higher, so I tend to “split the difference “accepting some asymmetry. We placed an Allergen 650cc SCF, High Profile “gummy bear “implant. She was very happy!
Breast Implant Revision / Replacement
SERVING SCOTTSDALE, PHOENIX, GILBERT, MESA, CHANDLER AND TEMPE, ARIZONA
This 45-year-old woman had her first breast implants placed 17 years prior, 380- Saline. She felt now, like she had lost upper pole fullness and wanted improved cleavage. She also wanted to be much bigger and liked the look and roundness of saline implants. She felt with a slightly broader shoulder she could handle a much bigger implant, and she did. We placed an Allergan style 68HP saline implant, 600cc and filled it to 700cc, which sounds really big but she loved the results and carries it well.
This shows the difference between a smaller saline implant and a larger silicone in the same patient. In 2005 350cc saline implants were placed and 12 years later, (and one baby) she desired to be bigger and see if she could get better cleavage as well. We placed 560cc Allergan SCM “Gummy bear” implants through the underarm using a Keller funnel, with a rounder fuller result.
This 37 year old woman had breast implants placed 13 years prior, through the underarm, but ABOVE the muscle. They were 300cc and 320cc Saline and over the last few years, she noticed more rippling. She then went and did and implant exchange and became encapsulated on both sides, even with silcone implants.
I then took her to surgery, removed her old implants and put in silicone 397 cc on the right and 421cc on the left...all through the underarm AND moved them to below the muscle. She really like the more natural new look.
This 31 year old who had a previous mastopexy/augmentation with saline implants under the muscle done in 2007 done elsewhere. She presented to me wanting her breast lifted off her tummy, much more fullness in the upper part and to be larger and to change to silicone. She also still had the dark portions of her areola that were left from the last operation along the bottom of her breast. I explained to her the difficulty of keeping a larger gel implant uphill in thin tissue that has already been stretched from prior surgery. I feel this is a case where extra support may be needed. We decided to use Strattice at the bottom portion of the breast, change her implants to 457cc Allergan, and redo her mastopexy and really is an example of "Cosmetic-Reconstruction". Her pictures 18 months later still show good upper fullness and her breast still up off her tummy!
5’4” 125lb. This patient had breast augmentation at age 19, with saline under the muscle 400cc. She did not like the scarring, wanted to be a bit bigger, and felt her implants had settled too low. We then did bilateral capsule tightening (capsulorrhaphy) and changed to 455cc saline. Her pictures 3 years later show her elevated, fuller at the top and better scar placement.
At 18 yrs old this patient had above the muscle saline implants placed through the belly button (TUBA method). Now at 24, and after 2 kids ages 2 and 8, she presents with small, rippling implants that are very far apart. Our thought was to try and give her a wider, softer look so we put new saline implants 420ccR, 390ccL now under the muscle with an incision under the breast, going from a 34 Small C to a 34 Full C.
5’8” 125lb. 45 yr. old smoker had above the muscle breast augmentation 330cc saline at age 33. At age 35 her R implant eroded through the skin and was removed…for 10 years! With very thin skin, we put new implants 360cc silicone gel under the muscle and a Brazilian mastopexy to lift her, all in one operation.
This patient presented with exactly what most patients do NOT want. Very firm, round, fake breasts. She liked a larger breast size but wanted a more “natural” fake breast! We took her saline implants out from above the muscle, and through an incision under the breast, moved 600cc silicone gel to below the muscle. Big, but better, a 32 DD.
5’7” and at age 27 this patient underwent above the muscle augmentation with 550cc saline. Now 11 years later, she presents with droop and distortion and desiring a smaller, lifted breast. We changed her to 480cc saline, moved them to below the muscle and did a lift on top of that, now a 34 C.