Breast Augmentation Revision – Patient 297

A mother of 2 in her later 40’s with a left breast implant deflation 2 weeks before seeing mye and breast ptosis ( drooping)
She had had breast augmentation 20 years before by a plastic surgeon who is now retired and described herself as a 36 D cup. She was happy with her size. She has had 2 children and breast fed since her surgery, and her breasts have drooped in appearance. She had her intial implant card showing mentor textured 325 cc saline implants. She had a capsular contracture on her right breast. Her initial surgery was transaxillary ( through the axilla) and her implants were above the muscle. She is active at the gym, and liked the lack of animation deformity ( movement of the implants with activation of her muscles( that is the tradeoff of placement of the implants above the muscles. However, there is a higher incidence of capsular contractrue both with a transaxillary approach and with a subglandular placement. She was sized in the office and liked a slight increase in size. There is a high risk of recurrence of a capsular contracture which can be decreased by changing the position of the implant to underneath the muscle, in a “new pocket”
At the time of surgery she had 350 cc implants filled to the maximum suggested volume of 400 cc and placed in a subpectoral space through an inframammary incision, combined with a periareolar mastopexy. At 5 ½ months after surgery her breasts remain soft, and her mastopexy scars have already faded nicely.