Breast Revision

Before And After Photos

This is a 37 year old mother of two, 5’7″ and 140 pounds who had a previous breast augmentation done elsewhere. She told me she wanted larger breasts and more cleavage.  On examination, she has laterally located breasts and a gap between her breasts. Her implants feel relatively soft and small in size. We discussed options at length. I felt that she would actually benefit from larger implants because they would fill out her dimensions better, and I would adjust the pockets so that her breasts would appear closer together.

I used her old incision beneath the breast and removed her submuscular saline implants that were 275cc in size. I adjusted the pockets on both sides and placed smooth moderate saline implants filled to 355cc on the right side and 420cc on the left side. I noted at the time of her surgery that her ribs were very sloped beneath her breasts and that there was significant differences in the size of her breasts.

She is seen in these pictures well over a year from her breast revision. You can see that her breasts are larger and fuller and they fit her dimensions much better. Her breasts are closer for sure, and her cleavage is more pronounced. She is wearing an excellent bra because this is mandatory because it will keep her breasts in the best position possible.

Learning points:

  1. Sometimes you have to go larger with your implants so they actually work best for your particular anatomy. The whole idea is to get the size right from the beginning. This is where I spend a lot of time with my patients during the pre-surgery counseling.
  2. I would have preferred silicone implants over the saline but she wanted saline.
  3. Since her ribs are sloped under her implants, they will always want to move laterally and down as they did the first time. The only way to keep this from happening again is to use a very supportive bra more often than you can imagine.
  4. Most surgeons talk about what beautiful breasts they make and how wonderful they are. What about talking about how my breasts will look five or ten years down the line? If this is a reasonable time line for you, then you need to know about choosing an implant size that is sustainable for the long term and you need to wear a great bra to provide long term support to protect your investment.
  5. I can guarantee you that her breasts would not look this good if she didn’t wear the bra you see in the pictures.
  6. Anatomically, some breast will get more cleavage after a breast augmentation than others. If your breasts are far off to the sides of your chest, you won’t be the patient who gets a lot of cleavage after an augmentation. However, you can expand the implant pocket towards the midline of your chest and this will allow you to move your implants towards the midline.