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Patient Details
This patient presented to me approximately 20 years after her original breast augmentation. Over time, her natural breast tissue had become increasingly saggy and was essentially falling off her implants, while the implants themselves appeared to be sitting too high on her chest. She wanted a breast lift/reduction with new implants that were slightly smaller.
An interesting part of her story is that both of her silicone breast implants were ruptured. Silicone implant rupture is not always obvious. Sometimes there are no symptoms at all. In other patients, the only clues may be increasing firmness or contracture, a change in implant position or breast shape, or discomfort.
I removed her old 325 cc smooth-walled implants and replaced them with slightly smaller 295 cc implants in the existing pockets. The implant pockets were thoroughly cleaned. Her breast implant capsules were normal and healthy appearing, so there was no reason to remove them simply because the implants had ruptured.
At the same operation, I reduced the excess, sagging breast tissue and removed and tightened the loose skin. This allowed me to reshape the breasts around the new implants and reposition the nipple-areola complexes to a more ideal location.
The concept is actually quite straightforward: new implants for old, remove the excess sagging breast tissue, tighten the skin envelope, and reshape everything into a higher, tighter, more youthful breast.
This is much more than simply exchanging breast implants. In an older augmentation patient, the implant and the breast tissue have often changed independently over many years. The goal is to address both—using the implant for appropriate volume and shape while simultaneously reshaping the patient's own breast tissue and skin around it.
The result is a smaller, tighter and more youthful breast that is better proportioned to her body.
