Breast Augmentation Revision – Patient 257

A woman in her late 20’s who had 350 cc high profile smooth round silicone implants placed by another plastic surgeon 7 years before. She felt that the implants were too large for her frame and also had “bottoming out”- placement of the larger implant evidently required releasing her infra mammary fold and it kept dropping to the point that her nipples would peak out of the top of her bathing suit. The breast fold is a ligament that supports the breast and the implant like a shelf. In her case when it was detached, this “shelf “collapsed and the implants dropped down too low. She also wished to have more cleavage.

Her implants were kept in the subglandular space and were exchanged for 255 cc round textured silicone moderate profile implants. Her infra-mammary folds were reconstructed and internal reinforcement was done with Strattice, which is a porcine dermal product that becomes part of the patients tissues and adds strength, and decreases the risk of recurrence. She is shown just before and again, 9 months after surgery. She is thrilled with her correction. The size is appropriate to her frame (5’9”/ 122lbs) and her fold is back and holding her implants in the proper position. This is a cautionary tale for patients that have an implant placed initially that is larger than their tissues can support. Lowering the breast fold should be done with caution, and the tradeoffs of an overly large implant may not be worth the potential problems that can develop.

UPDATE: Our patient is now seen 9 months after surgery. Her breast fold reconstruction has remained stable and her breasts have held their new shape.