Breast Augmentation Revision – 28 Year Old Executive
A 28 year old executive assistant wanted a revision of a previous breast augmentation. She had undergone a primary augmentation in a different city when she was 23, and was displeased with the changes that had occurred over time. Specifically, she felt that her implants had migrated towards her armpits. She was happy with the size of her implants and did not want to downsize (even though her implants were too large for her frame based on her anatomic measurements).
On examination, her implants had dropped significantly compared to the photos taken 3 months after her initial surgery, and the lower folds of her breasts were at noticeably different heights. Looking at her initial photo, you will notice that her breasts are different sizes – the right is larger than the left – and that her nipples normally lie on the outside of her breasts. After her augmentation, this size difference was magnified, and her nipples were now pointing to the ceiling due to the changes that the large implants caused to her breasts over time.
This type of result – which is very nice initially – illustrates the outcomes that are expected when implants that are too large for a particular body type are chosen. The soft tissue of the chest stretches and expands to accommodate an implant that is too large to support, leading to a number of deformities of the normal anatomy and the need for relatively early revisionary surgery.
At surgery, her existing silicone implants were removed and replaced with a similar volume implant of a narrower width. Doing this allowed Dr. Hall to shift the implant out of her armpit and more towards the center of her chest – you can see this very well on the side views. The size discrepancy was overcome by using two different implants – a 350cc high profile on the right and a 400cc high profile on the left – to equalize her breast volume. At the same time, the natural boundaries of the breast on the outside of the chest were recreated, and the breast folds were repositioned to the same level on each side.
At three months from surgery, she is thrilled with her results, and is eagerly looking forward to bikini season!