Breast Revision

Before And After Photos


This is a 39 year old mother of three, who is 5’3″ and 150 pounds who told me she had a previous breast augmentation done elsewhere. She told me she didn’t get what she wanted. She wanted a “lift” but her surgeon just put in implants. She tells me her breasts are not unattractive, they simply sit low and she wants them higher. I asked her about the scars associated with a lift and she told me she has no problem whatsoever with scars.

She is seen here some years after a bilateral breast revision. I removed saline implants and replaced them with smaller moderate profile saline implants in the same pocket. I also performed some liposuction of her breasts and removed about 45 grams of breast tissue on both sides as well. In addition to her breast procedure, I also performed extensive liposuction of her trunk and extremities and a full abdominal tuck.

Lessons to learn:

  1. Her muscle was quite retracted at the time of my procedure and I was unable to move it down so it would cover more of the implant. She did not want to use ADM or acellular dermal matrix to help with this issue. If I had it available I would have been able to build a more secure pocket to help support her breasts long term. ADM comes in handy in many cases of breast revision procedures. I tell all my patients that I would like to have it available at the time of their surgery and use it if I feel it is needed. I use it in about half of the cases of breast revision. It really can be helpful, if not critical in some cases. It would have helped me to “lift” her breasts considerably.
  2. She told me she had 325cc and 300cc saline implants at her initial procedure. It turns out that she had 325cc and 400cc implants. It is rare that what a patient tells me they have (by memory) in terms of implant size is accurate. Even when written down by the surgeon, the amount is typically not what I find at the time of surgery. Accuracy is important as I make my decision on implant size and style based on the information that they provide me.
  3. The “lift” in her case is made possible by actually reducing the bottom of the breast. I did this with breast tissue reduction with direct removal and liposuction. This makes the bottom of the breast less heavy and matronly and narrows the breast which makes it look more “perky”.
  4. You MUST try on implant sizers in the surgeons office to determine what size you will be. If you go simply by his/her own opinion you may certainly wind up with something that you didn’t want. Put the sizer in and look in the mirror. That reflection in the mirror is what you will look like. Computer imaging is just another way to see what it may look like but there is NOTHING more realistic than looking in the mirror with the different implant sizers.
  5. I did so much contouring around her breasts and abdomen with my other procedures that these pictures alone don’t totally reflect the big time change from the appearance of her pre-operative breasts.