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Breast Augmentation Revision: Patient 34

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This 40 year old patient came to see me 10 years after her initial augmentation.  She initially had 365cc saline breast implants placed by an excellent local plastic surgeon who is now retired.  She came to see me about revision breast augmentation.  I think it is vitally important that patients need to understand that breast implants don't last forever and will eventually need to be replaced.  Implants can leak.  Implants can get hard.  Bodies change. People gain and lose weight.  They go through pregnancies which often change breasts.  All of these things are not static and change is going to happen.  This patient was concerned about several things.  First of all, her saline implants rippled badly.  This is a function of the saline device but also that she is very lean with very little natural breast or fat to cover the implants.  Silicone will ripple much less, but not zero.  In addition the implants have migrated laterally and down over time, more on her left breast than the right.  She works out a good amount and this is something that can happen with chest workouts.  We discussed options and decided to place a very slightly larger implant (385cc) and move them more centered and higher to give her better cleavage.  In addition, Galaflex mesh was used to give the implants more support.  Galaflex is a mesh that can be used as a sling inside the pocket, often described like an internal bra, to give support to the implant.  This is an off-label use of the product and pros and cons need to be discussed in detail.  Mesh is often used in hernias and in other areas and many breast surgeons will use it in cases of implant displacement like this to give extra support.  She is shown here before and after her surgery.    Her pain is resolved.  She is much happier with the shape and position.  Rippling is significantly improved.