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Breast Revision Gallery Plastic Surgery in Austin | Patient 59

Patient Details

This is a 26 year old patient who is 5’6″ and 150 pounds who had a previous breast augmentation done elsewhere with saline implants. The right implant deflated about six weeks before surgery and the left implant was contracted. She liked the softness of the right breast and the more natural look than the contracted left.

She is seen here after removal of her saline implants in the partially submuscular position. I used her old incision that was around her areola. I completely removed both implant capsules. Her right implant was deflated and it was a 300cc labeled implant. The intact left implant was removed and it was labeled 300cc but was filled to 375cc of saline (this is actually more than is recommended by the implant manufacturer for this size implant).

I placed new moderate profile 375cc smooth silicone implants in the same pocket. Her pectoralis muscle was retracted towards her clavicle so in actuality, on the top third of her implant was covered by muscle. She enjoys a very nice result with soft, symmetrical breasts.

Lessons to learn:

  1. Even though she told me that she wanted saline implants at her original consultation because “they worked well for me and I have concerns about the silicone implants” I spoke with her at length about the differences in the two types of implants and she agreed to the silicone variety.
  2. Overinflation of saline implants makes them harder, rounder and more “ball like”. It’s generally not a good idea unless that is you goal.
  3. I cultured the implant pocket to look for “bacterial contamination” that is linked with implant contracture. It was “normal”. It should be noted, however, that they can still be present and the culture is negative. It’s not all or nothing in terms of this type of analysis.
  4. It would have been quite a challenge to adjust her breast pocket from the incision around the areola. I felt it wasn’t necessary or else I probably would have recommended a new second incision at the bottom of the breast.
  5. If the contracture was from an “indolent” bacteria (not strong but present), leaving the implant capsule in place would not be a good idea as it has the bacteria as well. That is why I removed the capsules.

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