Breast Revision Multifactorial Deformity
The patient below in her preoperative photograph shows an out-of-state augmentation mammoplasty performed by a different plastic surgeon. The patient is unhappy with the appearance of her breasts, the severe scar tissue contracture of the right breast with a ruptured left saline implant and the position of the nipple areolar complexes. She has severe pain in the right breast with encapsulation, double-bubble breast deformity, grade 3 ptosis and complete rupture of the left implant. The patient will undergo bilateral open periprosthetic capsulectomy, circumferential open capsulotomy, removal of ruptured saline implant replacement with high profile saline implants and formal mastopexy using the inferior pedicle Wise-pattern technique bilaterally.
The after results show still slight asymmetry of the left nipple areolar complex, slightly lower than the right. This will be correctable over the next six months. She however has nice placement of the implants after parasternal release of the parasternal attachments of the pectoral major muscle. The implants were now able, after muscle tissue expansion, upper pole compression band and accurate inframammary fold release, to have the implant positioned in a more normal configuration. The right nipple areolar complex sits nicely centrally. There is a little bit of inferior displacement on the left which will be elevated under local anesthesia, performing a left periareolar mastopexy.
The patient is very pleased with her results. She had severe pain in the right breast which as you can see has resolved as the implant is now positioned inferiorly in its normal pocket. She has good sensitivity bilaterally and is undergoing scar treatment including Bio Corneum scar therapy, continues with tissue expansion massage of the right breast. This is an example of a very difficulty multifactorial complex breast deformity by a transaxillary augmentation performed by a different surgeon, implant malposition, significant skin laxity that was not addressed and nipple asymmetry.