Breast Implant Exchange with Fat Enhancement

Amanda’s first breast implants were placed by another surgeon approximately 15 years earlier. 425cc anatomical saline breast implants were placed under the muscle. She was unhappy with the breast implant rippling, breast gap and muscle flexion distortion. Even under the muscle, the implants were still very visible as coverage was so thin. Being very lean also made her naturally wide breast gap seem even more prominent. Displacement and flattening of the implants occurred with every muscle contraction. Implants placed above the muscle would have resulted in more visibility due to less coverage. Implant placement under the muscle also created a wider breast gap visible in clothes. Rippling was more pronounced with saline implants especially when leaning forward.

Amanda first presented to our practice 10 years earlier for her tummy tuck. Her satisfaction and trust allowed her to feel confident in having breast surgery as well. Correction involved removing the implants and restoring the muscle to its original position. Placing cohesive, gummy bear, anatomical, silicone gel implants in a new pocket above the muscle. Then filling the overlying skin envelope with fat grafts to add cover, volume and cleavage

Amanda is seen at her initial visit four years earlier with her original saline breast implants The center photos show her four years after initial implant exchange to 350cc smooth, round, silicone gel implants (still under the muscle) with 50 cc of fat placed above. There was significant improvement but she still wanted to reduce the gap and muscle animation even more. As she was lean and also very athletic, she wanted complete muscle correction. Mentor MH 440 CC, anatomical, textured cohesive gel implants were placed over the repaired muscle. 75 CC of fat was also placed into the overlying breast envelope for coverage, volume and contour. She is now seeing with her final results 2 months after implant relocation and fat transfer. The fat grafts have completely integrated and have the potential to last a lifetime. There are no visible or palpable irregularities and full natural breasts have been achieved. Amanda went from a C to her desired D cup and… she finally has cleavage. The animation deformity is completely corrected and a soft natural appearance is finally hers.