This patient is 5’7″ and 140 pounds. She had a previous breast augmentation performed elsewhere and was not completely satisfied with the result. She didn’t like that her implants felt rock hard and that her nipple areola complexes were displaced down and to the outside of her breasts. She doesn’t like the overall shape and appearance of her breasts and thinks her implants are too high. She had her implants placed through the underarm area.
Indeed, on examination, she had rock hard implants and the overall shape of her breasts was not ideal. Her nipple areola complexes were not in a good position and they were different side to side. Her implants were high as they hadn’t dropped to the lower part of the breast. Her breasts are essentially “cockeyed.” She is seen in her post operative photos 5 years after her procedure. I removed her 300cc saline implants that were below the muscle and adjusted the pockets and replaced them with 350cc silicone implants and moved her nipple areola complexes to a more symmetrical, central position. I felt that the larger implant would actually fit her chest better (I always prefer the smallest implant that works to achieve our goal however). Her breasts are now very soft and natural. She has beautiful cleavage. Her breasts are shaped beautifully now and she couldn’t be happier or prouder. “You should put my breast revision case on your website to show people what can be done!” I can tell you that these pictures don’t do justice to what her breasts look like in person.
Of note is the darker scarring that she had from the surgery to move her nipple areola complexes. It actually looks worse in photos than in person. I told her that women of color can scar darker-and she has. For years I told her that I can treat this with mild acid peels and hydroquinones (bleaching agent used on the skin) but she told me she didn’t have a problem with these “blemishes.” Basically she was thrilled with the improvement from what she had before and this was a minor issue at best. I think I have finally convinced her to have the treatments to the area and see if we can lighten it up a bit. This case illustrates also that it is far more common to have problems “seating” breast implants through the transaxillary (armpit) approach than through the most recommended incision beneath the breast.
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