Breast Revision included silicone vs. saline and smaller from 320cc to 265cc

Breast implants are not permanent. Your body can change around a breast implant and the implant can change with friction. Most of the time the desire to revise implants is to reverse changes that occurred due to the force of time.     

Susan is a 47 year old mother of two, 5’7” and 115 lb. She is an avid soccer player and very athletic. In 2005 she had saline breast implants to restore lost volume after her pregnancies. Although she liked having an increase in breast size, there were a number of features about her augmentation that changed over the eight years since the original procedure. These are the aspects she wanted to improve.

1. She had a large gap between her breasts and the implants seemed to ride too laterally along the chest wall.
2. Her implants were larger than she was comfortable with, especially as a an athlete.
3. Her saline implants showed rippling, especially in the lower outer quadrant. She was self-conscious about this. 
4. When Susan flexed her pectoral muscle in workouts, the implant would move up on her chest wall.
5. The implants had a feel that was too firm.

Susan and I discussed at length the various choices she could make. In the end she chose the following revisions:

1. Use of a silicone implant for its smoother feel and decreased rippling
2. Revision of the implant position, by closing off the extra space on the lateral chest wall
3. Release of  the pectoral muscle in the lower, inner quadrant
4. Use of a smaller implant

At surgery her saline implants were taken out and found to be 320 cc in size. A 265 silicone implant was selected as a smaller size that fit well on her chest. Two rows of permanent sutures were placed along the lateral pocket to keep the implants where they belong (center of the implant under center of the nipple). The pectorals muscle was released in the lower inner quadrant of the pocket to eliminate the “animation” of the implant with flexion. 

At six months following surgery, Susan accomplished what she planned. The implant is well positioned on her chest, without the wide gap between her breasts. The size suits her preferences better and the feel is softer, more natural. She no longer has “animation” of her breast when she flexes her pectoral muscles. She is no longer self conscious about her breast appearance.