This is a 52 year old mother of two, 5’10” and 142 pounds, who had silicone implants placed above the muscle about twenty five years ago and now they are quite firm. In fact, her daughter told her that some of her friends noticed how firm they were when they hugged her.
You can see from her pre-operative photos that her breasts look somewhat distorted. The implants are sitting up high and the breast is falling off the implant with low-lying nipple-areola complexes. The breasts appear quite round and “ball-like” because of the contracture process. Her breasts were also tender and even painful at times.
We discussed all of her options at length. We elected to perform a breast revision – remove her ruptured implants and place new high profile implants in the submuscular position. We used 375 cc silicone implants. I preferred high profile because I wanted to narrow her wide appearing breasts (more youthful and projecting). We didn’t know the size of her existing implants so I used my best guess on size based on her anatomy and personal preference in terms of the way she wanted to appear.
It was a difficult procedure because it required a lot of dissection to completely remove her old capsule. The capsule is the scar tissue that develops around ALL implants. When it is this old it is usually calcified and needs removal so that it doesn’t distort the breast or interfere with future mammograms. I did not use ADM (Acellular Dermal Matrix) in her particular case but it certainly could have been used to help provide for internal support (it is common to use this material in breast revision procedures). I used drains in her case because I wanted to pull out the fluid that would certainly accumulate in the “old” subglandular pocket as she heals.
She is soft and natural now. You can see the difference clearly in the post-operative photos–a more natural “take off” of the upper breast, a better position of the breast implant that lifts the lower part of the breast, and most importantly, a very soft, natural feel. Best of all, she is a different woman now who invests in herself to a much higher degree than before surgery, because she has assets and not liabilities and because she looks as good as she feels. She passes the “hug test” with flying colors!
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