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This patient is a 35 year old female who came to my practice with complaints of heavy, unnatural appearing breasts after a prior breast augmentation. The patient had undergone breast augmentation by another surgeon who placed large saline implants over the chest muscles.

From the very beginning after her original surgery, this patient felt she was too large and found her breasts to be physically uncomfortable. Over time, things worsened as the implants thinned and stretched out the skin, and caused the areola size to enlarge significantly.

When I saw this patient, she was interested in having smaller, more natural appearing breasts. I recommended a number of maneuvers to correct her appearance. First, I felt we needed to downsize her implants and change from saline to cohesive silicone gel implants for a softer, more natural result. Second, I recommended switching the implant position from over to under the muscle to better blend the implant into her chest and to correct the upper breast "shelf" appearance. Third, I felt I would need to tighten the internal breast pocket so the implants would not fall off to the sides when the patient was lying down (see the closeup photos). Finally, I recommended significant tightening of the loose breast skin using an anchor scar lift pattern AND a circumareolar mastopexy (around the areola tightening) to create a perkier breast appearance and reduce the areola size.

I performed all of these maneuvers during this complex surgery, and used Mentor smooth, round, moderate plus profile cohesive silicone gel implants. I reduced the patient's implant size by 100cc's on each side, but by changing the implant shape and material, I was still able to provide improved cleavage.

After surgery, this patient noted an immediate improvement in her comfort, as her breasts were softer, smaller, perkier, and fit her body properly. She was extremely happy with her new appearance and her new level of comfort.


Provider: Dr. Cohen

Age: 35
Gender: Female