This patient is a 40 year old female from Montana who flew in to my practice for a revision of her prior breast implants. The patient was very unhappy with the appearance of her breasts which were too large, too widely spaced, and excessively low on her chest. The implants also caused her discomfort due to their heaviness.
Initially, when I saw this patient, she requested removal of the implants with a lift of the remaining breast tissue. However, on evaluation, I realized that she had almost no natural breast tissue left, and needed an implant to maintain a normal breast appearance.
I recommended a number of things to improve the shape and comfort of her breasts. First, I felt that switching from large saline implants to more modest sized silicone implants would make her breasts look and feel softer and more natural. Secondly, I recommended tightening the lower and outer breast pockets internally so the implants would stay in a perkier and more central location. Finally, I recommended a breast lift to remove the excess skin, tighten the breasts, and reduce the size of the areolas while repositioning them higher on the breasts. (Please note that the nipples/areolas stay completely connected to the breasts during this maneuver).
In the operating room, I performed all of the above mentioned procedures and switched the patient from 400cc saline implants to 325cc Mentor smooth, round, moderate-plus profile cohesive silicone gel implants. I tightened up the breast pockets internally to reposition the implants, and released the pectoralis muscles further in order to have better positioning and tissue coverage of the implants. After the internal work was done, I lifted the breast skin and nipple/ areola using a Wise pattern (anchor scar) skin removal technique.
The patient did extremely well after surgery and could not have been happier with her results. The postoperative photos were taken just over a week after surgery, and already the shape, size and positioning of the breasts are excellent. The patient is also much more physically comfortable with smaller, softer implants. (Please note that it is not typical for breasts to assume such a nice shape this early after surgery.)