Age: 36 years Height: 5’ 11” Weight: 169 pounds Preop: 36 D Postop: 36 D/DD Implant Size: 500 cc Left 550 cc Right smooth round moderate plus profile silicone implants Incision/Location: Previous periareolar incision used, submuscular Notes: This patent underwent previous breast augmentation elsewhere in 1999 with saline implants with a fill volme of 450 cc. She developed capsular contracture and severe shape distortion on the left side and underwent multiple revisions elsewhere without success. She presented to Richmond Aesthetic Surgery and Dr. Zemmel for additional revision.
The operative plan consisted of implant exchange to a larger silicone implant. Both implants where replaced through the previous periareolar incision. Complete capsulectomy was performed on the left side, including lower pole radial scoring to improve the roundness of the lower pole. The left inframammary fold was raised 2 cm with a double layered capsulorraphy suture. The left implant was brought more medial (towards the center) with a lateral capsulorraphy suture. Aceullar dermal matrix (alloderm) was placed internally along the lower portion of the left breast to increase the soft tissue thickness and reduce the risk of repeat capsular contracture. A lateral capsulorraphy was performed on the right side to medialize this implant. Finally, a periareolar lift was performed on both sides to tighten the skin and reduce areolar diameter.
She is shown 4 months after surgery and has markedly improved shape and texture. Both breasts are soft with a natural feel, and without capsular contracture. This patient is extremely pleased with her result.