Breast Revision

Before And After Photos

This is a 31 year old woman who is 5’7″ and 127 pounds who wanted me to remove the breast implants that she had put in by another doctor. She was a cheerleader when she wanted them, and she asked her surgeon to use the largest size possible. She felt pressure from her fellow cheerleaders and friends to go large. She told me that she had “perfect” breasts before her surgery.

She was augmented with 400cc saline implants. She complains that they are too large, too heavy and generally quite uncomfortable. She was so frustrated with them that she simply wanted to remove them.

Although I advised her that I can remove the implants and I believe her breasts will settle just fine, I also told her that after having such full breasts for so long it may be a bit weird having such smaller breasts. I told her that if she went considerably smaller and switched out her saline for the silicone variety, she can actually have really nice breasts that are comfortable and proportional.

She is seen here after I removed her saline implants and place 230cc moderate profile smooth silicone implants in the same submuscular pocket. She is extremely pleased with the change and told me that her breasts are more proportional and the difference between the saline and silicone is “amazing”. She told me the new implants are much softer and more comfortable. They simply feel a lot better.

Lessons to learn:

  1. A breast augmentation can be just about any size you want. Finding the right size is the key to success. This is where you should be spending all your education time to determine the best size for you.
  2. There is too big, too small and just right.
  3. Silicone implants are more comfortable and softer and more natural than the saline variety in most patients.
  4. When choosing a significantly smaller implant that what you have now, often the pocket needs to be adjusted to accommodate the smaller implant.
  5. If you had a lot of breast ptosis or sag associated with your breasts and you are changing to smaller implants, the breast is more likely to show signs of sagging as the larger implant is able to fill out the lose skin.
  6. Don’t choose a larger breast implant just to fill the loose skin. You may end up with larger implants than you like. This is where you need to consider the right size implant with a “lift”. Surgeon experience really helps in situations like this.
  7. The breast implant manufactures literature states an almost 30% breast revision rate after a first time breast augmentation. My revision rate is probably less than 2%. If you choose the right size implant for each patient, it is unlikely you will need to change the implant size over time. If you use the right technique when you perform a breast augmentation, it is unlikely that you will need to go back for additional procedures to “fix or adjust”. If you wear a supportive bra after your breast augmentation, your breasts will last longer and look better than if you don’t wear a bra.