Breast Augmention Revision Patient #21

A woman in her mid-40s with deflation of her right breast implant. She is shown before and again, 6 weeks after bilateral saline implant replacement.

Discussion:  She has had bilateral partial subpectoral placement of saline breast implants 23 years before by another physician, who has since retired.  She did well and was happy with her size and shape, but noticed a month before seeing me that her right breast started to get smaller.  We were able to obtain her old operative report from the surgery center where she had had her original procedure.  It mentioned the final fill volume of 375 but was inconsistent with the description of the implant size, mentioning 300 on one size “ filled to 375, which is within the desired limits of the implant. and 310 on the other  Mentor does not make a 300 cc high-profile saline implant. We were able to contact the manufacturer, Mentor, to open a warranty claim, and they had her in their database and were able to confirm that she had a Mentor 350-3310 on each side, which is a 310-round smooth high-profile saline implant that can be filled to 375.  So our detective work paid off.  She liked her original size and shape, even though it looked perhaps a little implant-like, with the implant pushing the limits of size that could be accommodated by her breast.  We kept the same size when I replaced her implants, and a capsulotomy was performed on her right to release the breast capsule, which had tightened around the deflated implant, and an inferior capsulotomy on her left to allow the implant to sit a little lower. At 6 weeks, she is doing great. We have just removed her steri-strips, and the discerning eye may notice a little tape residue under the breasts.