This patient is a 40 year old female who presented to my plastic surgery practice with interest in revision breast augmentation surgery. The patient was noted to have a severe right breast deformity as well as medial malposition, asymmetry, and drooping of the left breast.
This patient had undergone multiple prior surgeries by other physicians, with the most recent surgery being performed by a non-plastic surgeon who released her right chest muscle from its natural attachments causing the flexion deformity and severe malposition noted in the photos. The patient was also interested in an abdominoplasty.
With regards to the breasts, I recommended an implant exchange from saline to silicone, removal of old scar tissue, and pocket reconstruction with resuturing of the pectoralis muscle to its original insertions. I also recommended using Strattice (an acellular dermal matrix) to reinforce the central repairs, and to also act as a lower breast sling (internal bra) to support the implants. Finally, I recommended a tightening around the areolas to improve the areolar positions, size and symmetry.
For the abdominoplasty, a modified procedure was needed due to a large upper abdominal scar from a childhood surgery. I recommended a limited central dissection with an umbilical float to improve the abdominal appearance.
During surgery, I performed the above-mentioned procedures, and used a full piece of Strattice Contour 3 on each side, with the pieces divided into two parts to reinforce the midline correction and to also act as a pectoralis extension.
After surgery, the patient could not have been happier with the dramatic improvement in her breast appearance, and she was quite happy with the improvement in her abdominal appearance as well.