Patient - Combined Breast Procedures

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Before

This patient came to see me in 2010 because of loss of volume and sagging of her breasts after two pregnancies. I thought she would do well with breast implants alone and proposed that. She underwent augmentation with Mentor smooth, round moderate profile saline implants placed under the muscle. She did very well and looked good up to her 3 month postoperative visit. For reasons that she could not explain, she never returned for her final visit and photographs, so I do not know how she truly turned out. She said she was very pleased. 

She returned to see me in 2019 for several reasons. She had gained weight and no longer felt she needed her implants. In addition, she had a number of medical issues and was concerned that some might be tied to her implants. For these reasons, she sought to have them removed. Nothing about her exam suggested a problem with the implants. Her breasts looked and felt very natural and the implants were soft. Her breasts had grown substantially in those 9 years. 

Here she is in 2019. 

After

I removed her implants and performed a mastopexy (breast lift). I found that her implants looked very much like the day they went in. The capsule (scar) tissue was so thin and filmy that I did not feel that removal of this was necessary or even advisable, as it would have been difficult and bloody to do. Some argue that the entire capsule must come out. I disagree in such cases and there is no consensus on this. She was very happy with her final result. Six months after removal of her implants she reported that many of the problems she was experiencing were either gone or much better. It is impossible to say what, if anything, the implant removal had to do with this. Many patients who have multiple complaints and have their implants removed feel better but others do not. Some of this could be the placebo effect but there may be some real benefit to a small group of women who are unusually susceptible to silicone implants. More studies are needed on this subject. I am just glad she felt better.