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Breast Augmentation: Patient 334

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Revision breast augmentation is a complicated surgery which needs to be individualized carefully for each patient.  The surgeon needs to consider her anatomy, what types of breast implants she has, the pockets of the implants, any healing problems or complications during her previous surgeries, if the implants are intact, what has happened over time to the implants, body changes and her natural breast tissue around the implants and many more considerations.  This is a 27 year old patient who had her original breast augmentation performed in Ecuador with Ultra High profile Implants also known as Corse profile implants.  Implant profile is an extremely important concept to understand.  I explain profile to prospective patients with the following analogy.  If you take a pitcher of water and pour it into a bowl, the water fills the entire bowl and does not come up very high.  If you take the same pitcher of water and pour it into a mug with a smaller diameter it will come up higher in the mug.  Pour the same amount of water into a bud vase and the water fills the column of the vase and comes up very high.  It's the same amount of fluid poured into different shaped containers.  With a low profile implant it is a wide diameter like a soup bowl.  With a moderate profile it comes up higher and is more narrow than the larger diameter low profile.  With a high profile implant it comes up very high and narrow like the bud vase.  This patient had ultra high profile implants.  This means they are very narrow and stick out or project a large amount.  You can see in her before photos as they look odd as they do not fill the width of her chest.  This is an important concept to understand as the implant must match each patient's chest width.   I revised this patient by removing the old implants, reshaping and repositioning her pockets and placing an implant Demi profile which better matches her chest width.  I went from a 260cc implant to a 425cc implant and supported the implant with Galaflex mesh as an internal bra.  It is important to explain to people that mesh used in the breasts is an off-label  usage of mesh and yet often it is an important usage for soft tissue support in thin and damaged tissues that plastic surgeons use.  I do not believe in using mesh in every single breast augmentation as there is no need for it in most breast augmentations and it is not approved by the FDA for general use in all breast augmentation patients.  As a surgeon and physician there needs to be a good reason to use off label products and the patient needs to be educated on pros and cons of these options.  She is shown here before and after revision at 6 weeks and delighted with her results.