This patient is a 29 year old female who presented to my medical practice with complaints of unnatural appearing breasts after prior breast augmentation by another surgeon. Specifically, she was unhappy with the wide spacing, lateral (outer breast) fullness, and rippling of the implant edges.
To obtain a natural breast appearance, I felt that I would need to 1) change the patient from saline to cohesive silicone gel implants, 2) perform extensive internal pocket revisions (including both internal stitching to tighten the lateral pockets, and tissue release towards the upper and middle pockets to create better cleavage), and 3) perform an external tightening of skin around the areola (circumareolar mastopexy) to reduce the areolar size and to even the areolar positions.
In surgery, I removed the patient's old implants which were 350cc saline implants overfilled to 400cc on the right and 435cc on the left. I performed multiple layers of internal (inside the breast pocket) stitching to reposition the implant upwards and towards the middle. I also further released her chest muscles and created more space in the upper and middle pockets. I placed Mentor smooth round, high profile cohesive silicone gel implants and used a 400cc on the right and a 425cc on the left for the best symmetry. Finally, I adjusted the nipple/areola size and positions using a circumareolar mastopexy (around the areola breast tightening).
After surgery, the patient recovered very nicely and was extremely pleased with her softer, rounder, and natural appearing breasts. The rippling was completely resolved, and her breasts had a much better position and proportion to her body. Please note that the marks on the patients postop photos are temporary indentations from her bra.