Breast Gallery
Implant Deflation 01a
Description:
Patient 26 year old wanted a fuller breast size in proportion to her body.
She was 5’6” 145 lb. 34 -36 B before her surgery.
Breast augmentation under pectoralis major muscle via periareolar incisions using smooth round saline implants 420cc minimum fill volume filled to 450cc on each side, intermediate profile. IV local anesthesia by surgeon
Post op bra size 36D very soft and mobile.
She had 2 children and gained weight to 200 pounds during the second pregnancy 2 years before these after photos.
She had no problem breast feeding her children after her breast augmentation procedure with periareolar incisions.
Breast were very soft and implants difficult to detect as they moved very easily with the lightest touch within a large pocket.
After pictures 9 years 10 months after surgery when she returned to the office feeling the R breast had become softer and smaller starting about 2 previously but had not gotten any smaller. Exam 5’4” 135 lb. 36 C or D brassiere confirmed R side significantly smaller (~75 cc = 5 Tablespoons) Most likely the R side developed the smallest pinhole leak. As there is minimal pressure on this implant as very lax skin, capsule and very mobile implant, implant did not deflate all the way. She has elected to replace both as she is just within the manufacturers 10-year warrantee period. She restored original implant size plus 30cc (2 tablespoons) more volume to each side. photos not yet available.
Breast Revision 02a
Description:
Breast augmentation revision: 4’11” 120 lb. 34C lady after augmentation elsewhere 9 years prior. Breast augmentation sub muscular with saline PIP breast implants.
L side was noted to be deflating in the shower after going for a run days prior to consultation. (“PIP” pre-filled saline implants from France or Poly Implant Prosthesis implant shells were high temperature vulcanized that made them softer but more abrasive. They are now are known to deflate much more frequently. The FDA took them off the US market May 2000. Current saline manufacturing uses room temperature vulcanization techniques so the shell lasts much longer.)
She wished a little smaller breast volume than the 325 cc originally placed on each side. A natural look was desired so no breast lift was performed. Silicone implants were selected. Intermediate profile was chosen consistent with her breast measurements. Her original breast tissue was palpated to be larger on the now deflated L side. 225 cc smooth gel implant was selected for the slightly smaller R breast and 200 cc gel for the slightly larger L.
Post op photos taken 3 months after her surgery. She “loved it” and is “really happy” with her smaller size and ongoing “natural” appearance. She could still wear many of her 34C brassieres although some 34C now too loose. She noticed her nipple sensitivity had increased.
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.