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 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 female in her late 30’s at first was thinking of doing a breast lift without an implant, however I explained that it’s the implant that gives just a little upper pole fullness and she did want that. We used Allergan style SSM silicone gel implants 255cc on each side placed completely submuscular. A Brazilian lift was done on top of that giving her a small C cup, however she also requested liposuction of her front underarm area that she felt bulged out of her bra. We do it often and it’s a nice, little addition that patients really love.
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 young woman in her mid-20s had one child and was unhappy with the shape and size of her breast. She decided on a breast lift without implants to be able to exercise more easily. This is her over four months later with her scars still slightly pigmented, but very happy.
This 43-year-old patient told me she never had the breast shape she ever wanted. As soon as she hit puberty they started to droop! For her, just a straightforward mastopexy was all she needed. She wanted to reduce the size of her areola and have them face more forward. She had good breast tissue density, so it gave her good upper pole fullness, almost like having an implant!
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 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 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.