This 42-year-old is a classic example of a breast implant revision going from an above muscle breast augmentation years ago to an under the muscle implant exchange with a lift. Her original implants were 350 mL textured silicone implants above the muscle and over the years her skin and stretched quite a bit. She was now complaining of a hanging sensation as well as loss of volume in the upper pole. She really didn’t want to be much smaller, just more support and better cleavage. In surgery, I removed her old implants and opened the space under her muscle. I used part of her old capsule to support the implants which were 375cc Allergan SCM gummy bear implants. I then did a Brazilian superior pedicle lift on top of it all. Her photos are now 13 months postop with still very good support to her implants and breast tissue!
SERVING SCOTTSDALE, PHOENIX, GILBERT, MESA, CHANDLER AND TEMPE, ARIZONA
This 46-year-old patient shows how with a well-constructed lift, you can go with larger implants and still maintain the lift. I usually discourage patients from going with too large of an implant with a lift because of the difficulty in keeping it uphill and maintaining upper pole fullness. So, this patient went with a lift and 255cc implants at our first surgery. She then decided to be larger and by waiting almost one year we were then able to place 415cc Allergan SCF silicone implants and still showing a great lift up off her tummy, 18 months later.
Again, one of the biggest challenges in mastopexy augmentation is how to keep the implant uphill and give the patient fullness in the upper pole. Almost all patients seeking a lift have lost that and really would like to get it back and it is the implant that does so. This is why in almost all cases of mastopexy augmentation I keep the implant completely covered by muscle. It acts as an internal bra and holds the implant high. And it doesn’t take much implant to achieve this. We placed a 295cc Allergan style SRM implant under the muscle completely covered and then did a Brazilian lift on top of that with the results showing good upper fullness nine months later
This 35-year-old female had lost breast volume following breast-feeding. She now desired a C cup and very natural wanting to avoid that high riding breast look. Her rib cage showed an indentation at the lower sternum and flaring of her ribs on the lower left side. She was also slightly larger on the right than the left. I used a 300cc Allergan style SRLP silicone implant kept completely submuscular with a Brazilian lift on top of that. her results are shown one year later still holding a very full, natural look.
This active 33-year-old female felt that after childbearing her breasts had drooped to where she felt they just didn’t fit her body. She was looking to be a full C and we did a Brazilian lift keeping the implant completely under the muscle with 295 mL Allergan style SCM. But I think this patient also illustrates that at six months her breasts are still up off her tummy and her scars are still visible.
This 28-year-old patient that presented with grade II ptosis bilaterally (nipple below the inframammary fold) and desire to be into a good D cup. This requires a placement of a larger implant and the challenge in breast lift with an implant is to keep the implants “uphill” with tissue that is stretched and non-supportive. We used an Allergan style SCM gummy bear silicone gel implant 445cc bilaterally and then performed a Brazilian lift on top of that. Care was taken to retain some supportive tissue beneath the implant and then postoperatively we locked her into a Victoria’s Secret knockout bra, which is our go to support to hold implants in place. Her results as seen almost one year later, with her breasts still up off her tummy!
This 44-year-old woman felt her breasts just did not fit her body tight. She was a DD and felt very droopy. She wanted a smaller breast size and lift as well but not interested in an implant. A Brazilian type breast lift was performed and her results, eight months later show a much more athletic look, which was her goal!
This 61-year-old patient is a great example of a revision surgery that is becoming much more popular. She had saline implants placed 12 years prior, 450cc on the left and 400cc on the right. She felt now too low in both the position of her implants and breast tissue, wanting now to be smaller and perkier! We went to surgery and did work on all areas, replacing her implants with 360cc silicone, tightening her capsules, and doing a full breast lift, and 6 months later she is right where she wants to be.
This 41-year-old patient is a great illustration of a few principles. She had original augmentation surgery in 2004 with saline implants over the muscle. She felt too low and her saline implants were too slushy. She wanted to be lifted, more fullness in the upper pole and change to silicone. We decided to not only change her implants (Allergan 310cc) and do a lift but move them to under the muscle as well. By keeping the muscle completely intact and doing a Brazilian superior pedicle lift which eliminates droopy tissue at the bottom, she now has upper pole fullness and as her photos show almost 2 years later (too many “after lift” pictures are shown too soon after surgery..)they are still up off her tummy, passing the pencil test!