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Breast Augmentation Revision: Patient 40

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This patient is 4 years out from breast augmentation by another surgeon.  She had 380cc  Mentor Ultra High Profile implants placed in a subglandular position.   Unfortunately she does not have the fullness nor cleavage that she was hoping for.  An ultra high profile implant is a very narrow implant with very little height.  It projects and this is where the volume is delivered out from her chest.  The implant is not wide enough to fill the width of her natural chest diameter and she is left with a lackluster result.  She wants to be larger and I switched to her a full profile implant which is wider and taller than the implant she has.  I also switched her to the most cohesive SCF Allergan Natrelle implant as this thicker more filled implant device will deliver more upper pole than if I used a responsive SRF or softtouch SSF.  As upper pole is one of her desires this is the implant for her goal.  I increased to 650cc as she is looking for significantly more volume.   Finally I used galaflex mesh as an internal bra to give her extra support.  These implants are larger and the weight of the implant will benefit from the support.  Mesh is off-label for breast augmentation and the pros and cons of using this in individual cases needs to be discussed in detail with each patient.  I get lots of patients coming in asking for mesh on primary breast augmentation and to me that is usually inappropriate and not necessary.   As in all revision breast surgery these decisions must be made on a case by case basis with clear understanding of options active in the decision process.