This patient is a 33 year old female from Hawaii who presented to my medical practice with complaints of unnatural appearing breasts after two prior breast augmentations by another surgeon. Specifically, she was unhappy with the wide spacing, lateral (outer breast) fullness, and the apperance of her areolas.
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 with a lollipop incision (mastopexy) to reduce the areolar size and tighten up the skin.
In surgery, I removed the patient's old implants which were 425cc saline implants on the right and 460ccs on the left. I performed multiple layers of internal (inside the breast pocket) stitching to reposition the implant upwards and towards the middle. I placed Mentor smooth round, moderate cohesive silicone gel implants and used a 350cc on the right and a 375cc on the left for the best symmetry. Finally, I adjusted the nipple/areola size and tightened the skin using a lollipop incision (vertical mastopexy).
After surgery, the patient recovered very nicely and was extremely pleased with her softer, rounder, and natural appearing breasts.