Breast Revision (Strattice ACD) 01a

Description:

23 y.o. underwent TUBA (Trans Umbilical Breast Augmentation) implants 550 cc saline filled smooth surface moderate profile implants placed on each side by another surgeon. The left side deflated the next day and was replaced. Over time the implants “bottomed out” i.e. the lower part of the breast tissue stretched out allowing the implants to settle too far. When she laid down her breasts “disappeared” sliding off to her sides. There was diffuse rippling.

Her goals were:

“Wants breast to look amazing!”

“Reduce rippling inner and under her breasts”

“Lifted “playboy status” higher look”

“Feels weighed down by drooping breasts”

“Reduce weird upper inner shape”

Exam 2 years after her initial surgery 5’5” 110 lb. 32D confirmed diffuse rippling as she was razor thin with only 1/8” of tissue covering the implants. The implants had settled too low so the nipple/areola looked too high on the breast mound. The implants did slide too far off to the sides when she laid down. She thought the implants were placed under the muscle but they were actually on top of the pectoralis muscle. Right side was a little larger than the left.

Plan and surgery:

Although removing saline filled implants and replacing with silicone filled implants reduces rippling she did not feel comfortable using gel implants.

Place implants under pectoralis muscle to give more natural inner/upper breast shape and minimize rippling.

Use high profile 460 cc saline implants filled to maximum 550 cc to improve shape, minimize implant folding/rippling, and maximize implant projection to 6.9 cm.

Place capsule tightening sutures to reshape the stretched out implant pocket and correct the bottoming out and sideward slide.

Use Strattice ACD (Acellular Dermis) to support the implant in the new higher position, add more tissue to cover the lower part of the implant to minimize rippling, minimize breast motion (“animation effects”) in the new sub muscular location, and minimize chance of settling too far again.

Access via periareolar incision, general anesthesia used.

Old saline implants removed had volume on R 586 cc and L 535 cc accounting for her asymmetry.

After surgery:

She noticed her arms no long touched the sides of her breasts even as she walked from the operating room to the recovery room.

She is really happy with the outcome and has received many complements about her breasts.

Size 32 D fits well although often wears Frederick’s 34 D shelf bra.

After photos taken at 5.5 months after surgery.