This 48-year-old started in very good shape but does present with a couple of challenges. She had breast implants placed 21 years prior and now noticed her breast sitting a bit too low and touching her tummy. We changed her implants from saline to highly cohesive gummy bear implants (375cc) and also put sutures in the pocket to raise the implant position just a bit. I performed a Brazilian breast lift, raising her nipple and removing the entire droopy, lower pole of breast tissue. And nine months later her breasts are still not touching her tummy!
SERVING SCOTTSDALE, PHOENIX, GILBERT, MESA, CHANDLER AND TEMPE, ARIZONA
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!
This 41-year-old patient originally had saline implants placed in 1997. She felt they were overfilled and gave her too much upper pole fullness and was looking to be smaller and lifted. Her left implant also moved too far to the outside. At surgery I did a left capsulorrhaphy, changed her overfilled saline implants to silicone 345cc and did a Brazilian breast lift, again changing all three breast revision components. We kept her for six weeks in our “knockout bra“ protocol with a very natural result.
This patient presented with a breast lift and implants 15 years prior. She had 400cc silicone gel implants and now presented wanting her breast tissue tightened and her areola made smaller. During surgery I discovered she had a silent rupture of her right implant. I removed the rupture, changed her implants to 400cc silicone gel on the right and 375cc on the left, and resized her areola and redid her lift. She is shown now seven months postoperatively.
This patient presents with one of the more challenging scenarios in cosmetic reconstruction. I often talk to patients of the three components of revision surgery being capsule, breast tissue, and implants and in this patient, we changed all three. Her original implants were saline, then later changed to 600 cc silicone implants with a lift. Now seven years later she desired to be smaller, breast tissue lifted and more upper pole fullness. We performed bilateral capsulorrhaphy to raise up the implants to a higher position, went to smaller implants 450cc Allergan style SCF. We then repeated a breast lift using a Brazilian technique, all performed in one single surgery!
This is a very straightforward breast lift only with no implant. The advantage implants give is usually a little more fullness in the upper pole, but many women choose to just be smaller and go without. This patient was tired of the breast sitting too low and feeling too heavy and was really looking to be much smaller… her result is shown seven months later.
This 57-year-old patient had a long history of breast implants going back to saline implants which were later replaced with textured silicone. She now felt too full in the upper pole, too big overall and felt that her breast tissue was too low. A straightforward way to reduce upper pole fullness is with a smaller implant and we went from a 360cc down to a 250cc Allergan style SCLP. To address the drooping breast tissue, we tightened her up using a Brazilian lift. So, to achieve her desire of a smaller, tighter breast, we reduced her implant and reduced and lifted her breast tissue. Her results are shown 15 months after surgery. They are right where she wants them to be!
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.
This patient presented with grade II droop and really was looking for a classic left result… Nipples more in the middle of her breast, more upper pole fullness and her breast tissue off her tummy. We placed Allergan style SRM silicone gel implants 310cc completely under the muscle and then did a Brazilian lift on top of that which has the benefit of eliminating a lot of the lower breast issue which in other techniques can begin to droop within a few months. At almost a year later she is still up off her tummy, with good upper fullness and nipple position.