Breast Revision Gallery Plastic Surgery in Austin | Patient 62

Patient Details

This is a 56 year old mother of two who is 5’8″ and 138 pounds who complained of a deflated right breast implant. She told me she had a lift on the right as well as an augmentation. On examination, she had a deflated right breast implant, ptosis of her breasts and extreme displacement of her breast implants under her arm when she laying down. Literally, her implants moved under her arms and she had a bare chest showing only. She seems totally disinterested in her breasts or her outcome from anything I could do. Does she want a lift? Does she want them larger or smaller? Silicone or saline? Do you want to remove the implants altogether? I felt that she really wasn’t engaging her breasts at all—there was no excitement.

She didn’t want a lift for whatever reason. She told me that the right breast started off a lot larger than the left breast so that her surgeon put in different breast implant sizes. They were saline, submuscular implants. The plan was to remove her implants, replace them with what I thought would be larger implants, and adjust the pocket to keep her breasts up front where they belong. At surgery, I removed a deflated right implant and an intact 325cc saline implant on the left side. I closed off the pocket around the implant along the lateral breast so the implants would no longer go under her arms, and I placed saline implants in the same pockets (375cc on the left and 350cc on the right), and I removed some breast tissue on the right side. She is seen here about 9 months out from her surgery. She is very happy with the breast revision procedure, and had totally engaged her breasts as something special.

Lessons to learn:

1. Lateral displacement of the breast implant happens when your surgeon develops a pocket that extends too far to the side, or if your implant is allowed to stretch a pocket off to the side because it is not properly supported with a bra. Back sleeping would make this happen a lot easier. The rib cage of most humans is sloped on the sides to think of your implants sitting on a hill. They will slide down the hill over time if not supported.
2. The surgeon chose to use two very different implants to provide for a size match. I am more inclined to adjust the breast itself and use the same size implants or at least split the difference to some degree. If you have two dramatically different sized implants you will notice the breast actually looks and FEELS different because of this. Breast tissue does not necessarily feel like implant and the ratio of the two is an important consideration.
3. I chose larger implants because I thought it would actually fill her dimensions a lot better, and I think it did. Also, without a lift, this larger size would make it appear that she actually got some lift.
4. A lift can always be done as a secondary procedure if that’s what the patient prefers—you aren’t burning any bridges. It is usually obvious to my trained eye who benefits from a lift and who may “get away” without one. I am a big help with this intricate decision (experience really matters here most).