Revision Breast Surgery

48 year old mother of two. She originally when she was 20 had 600cc implants placed. She later went on to switch them to 375cc. However she was getting recurrent capsular contracture and this was causing pain. After her fourth operation elsewhere she came to see us. She is a busy executive and exercise is very important to her. Her breast implants were significantly impacting her enjoyment of exercise daily and she also felt her breasts were too large at this stage in her life

Surgical Plan

• Remove the breast implants and capsule as needed
• Replace the volume with fat
• Lift the breast with a breast lift

46 year old mother of 3. She had 450cc implants placed when she was 20 years old. After breast feeding she had a lift performed. Her main concern for coming to see us was the “animation deformity” which is an akward look of the implants with movement and she felt at this stage of her life her breasts were simply too large and inappropriate

Surgical Plan

• Remove Breast Implants
• Anchor Pattern Breast Lift
• Custom cleavage with fat grafting

46 year old mother of 3. She felt that her breast was falling off of her implants. She wanted a
smaller more elegant lifted look

Surgical Plan

• Remove Implants
• Replace Implants
• Vertical Breast Lift
• Fat graft for custom cleavage to give an in bra look without the bra
• Internal bra
• Capsule change

36 year old mother of four came to see us for a mommy makeover. She had 360cc smooth round silicone implants placed under the muscle before her kids. After four kids and four rounds of breast feeding her concerns were the following:

1. My implant has bottomed out
2. When I lay on my back my implant falls into my armpit
3. My tissue is thinner our from breast feeding and I look Deflated

Surgical Plan

1. Remove old breast implants
2. Tighten lateral capsule so implant does not fall into armpit
3. Release capsule closer to the sternum
4. Put in new implant
5. Secure position of new implant with internal bra
6. Lift the fold and lock it down to the chest wall with internal bra to prevent bottoming out
7. Put purified fat over implant under skin to fill in areas lost from breast feeding

This 37 year old mother of 3 had 375cc implants placed under the muscle when she was in her early 20’s. She had no pain or concerns about the implants placement, with weight changes and breast feeding from pregnancy she asked if we could lift her breast over her existing implants while we do a tummy tuck.

58 year old mother of 3 had 390cc textured implants placed below the muscle 6 years ago in Europe. This was done to address what she felt like was breast droop.

Her Main Concerns

1. My breasts are too large
2. My breasts are too wide
3. My implants fall into my armpit when I lay down
4. My breasts feel droopy
5. I look big and the fashion I like is more slim and elegant

Surgical Plan

1. Remove old implants
2. Custom pocket creation
3. Long acting numbing- Exparel
4. New more elegant shaped implant
5. Breast lift to reshape and restyle the breast

38 year old mother of two. Had the recalled style 410 allergan implants placed under the muscle about 10 years ago. The recall does not mean all women with these implants should have them removed. The FDA says the surgery is not worth the risk unless a woman is having symptoms. Signs and symptoms of rare lymphomas may include lumps, pain, swelling, and asymmetry (breasts look different from each other). This patient felt the breasts were painful and appeared odd. On examination she had firm capsular contracture (Baker Grade 3)

Her Concerns

1. They are hard
2. They are high
3. I like the volume

Surgical Plan

1. Remove old implants and send for pathology
2. Remove capsule and send for pathology
3. Switch from below to above muscle
4. Replace textured implant with smooth implant
5. Add structural and purified fat “like butter on toast” to improve the finesse appearance of the breast

Before Photos

After Video

34 year old Florida patient came to see us with concerns over her implants. 

Her Concerns

1. She exercises a lot and does not like the feel of them anymore
2. She has had multiple surgeries over the years for capsular contractures
3. She stated, “I am tired of these implants”

We were able to remove her implants, most of her capsule, and we used a combination of structural and finesse fat grafting to give her an elegant and natural look

40 year old mom of 3 came to see us complaining of painful irregular breasts 6 years after breast augmentation. She noticed the implants became hard and had an irregular appearance.

Surgical Plan

1. Implant removal
2. Capsule removal
3. Move new implants from under to above muscle
4. Post-op aspen system for capsule control

This patient came to see Dr. Anna after having multiple breast augmentations in the past. She had obvious concerns over asymmetry and irregularities in look and feel.

Surgical Plan

1. Implant removal
2. Capsule change by selective release otherwise known as capsulotomy
3. New gummy bear silicone implant customized to desired shape
4. Structural and finesse fat grafting to correct tissue deformities  and asymmetries from previous surgery

37 year old mother of 2 with 240cc implants placed through the areola came to see us complaining that her implants were falling into her armpits when she lies down and in her abdomen when she stands up.

Surgical Plan

• Change to infra mammary incision
• Remove implant
• Lateral popcorn capsulorraphy
• New implant -335cc smooth round silicone gel
• Insertion of galaflex internal bra
• Fat grafting for cleavage

Here is an example of implant malposition

Showing the internal bra holding the implant where we want.

Old implants removed

Internal bra vs. no internal bra

Fat grafting to cleavage

Preparing the internal bra

35 year old mother of 3 who had breast augmentation before her
children. After breastfeeding she felt as though her breasts became
droopy and lost there youthful look and feel. She also had congenital
sternum and rib irregularities

Surgical Plan

1. Remove old implants.
2. Close pocket laterally with popcorn technqiue.
3. Place new implants.
4. Insert internal bra to hold the implant up the slope of the rib deformity.
5. Fat graft the the sternum and cleavage.

• The breast was falling off the implant
• The implants were too high and too big
• She did not like the shape

Surgical Plan

1. Take out the old implant
2. Release the capsule
3. Insert internal bra
4. Insert new 190cc low profile implant
5. Modified anchor pattern lift
6. Micro fat for custom cleavage
7. Nano fat for chest sun damage

43 year old patient had her textured implants removed. She decided she wanted to add volume so we used 275cc saline implants and fat grafting to reconstruct the breast.

This 43 year old woman came to see us for complex breast, reconstruction and revision surgery. She had multiple breast augmentations with silicone implants. In the past. Her main concern was that her breasts were hanging off of her implants, and that the implants or falling into her armpits, and that when she flex her muscles, the implants will go up into her shoulders.

We took her to the operating room. We remove the old implants. The left implant had ruptured, and there was silicone within the capsule. The right implant was completely intact. We found a new home for the new implant by dissecting a New subglandular plane and obliterating the old plane and capsule. We downsized her implants to a more age-appropriate and elegant size, which was approximately 250 cc from 450 with then inserted an internal bra and performed an anchor pattern Breast Lift to treat contour deformities and deficient cleavage we injected purified fat into the breast.