Please see this 52-year-old female before and after her breast augmentation revision of aged breast implants. She had her prior smooth saline implants removed and replaced and a breast lift to correct her skin looseness.
Breast augmentation revision of aged breast implants is designed to correct the sagging appearance of your prior breast augmentation surgery. Two factors determine the scope of your breast implant revision surgery. The first consideration includes the integrity of your aged implants. They may have become compromised through decades of aging such that the silicone material on the inside is microscopically leaking through the silicone implant shell. A silicone bleed is the microscopic oozing of silicone molecules through the shell. A more aggressive leakage of the breast implants may involve a tear in the implant shell, resulting in gross contamination of your breast pocket with silicone gel. A more generous silicone leakage inside the implant is termed an implant rupture. When implant ruptures in silicone implants are left unattended, the silicone material may penetrate the breast tissues, such as the capsule, and even deeper tissues, such as the local lymph nodes. The next consideration for the optimal treatment of breast augmentation revision of aged breast implants is the loose skin. Skin looseness is a natural and unavoidable consequence of implant and breast aging. After the age of 40, the body begins to lose the ability to produce a protein called elastin, that is responsible for much of our skin’s elastic ability. Therefore, even the best breast augmentation surgeries may need revision after several decades. Realistic expectations can only be offered once the scope of the breast revision surgery has been identified.
Scope of work to complete a breast augmentation revision of aged breast implants
The scope of work needed to complete a breast augmentation revision of aged breast implants will be determined at your initial consultation. This consultation will involve a thorough history of what initial breast surgery you had done and all subsequent breast surgeries. Breast sizes should be discussed as this will affect the choice of the replacement implant. If you require the removal of your capsular contracture or need a breast lift, tissues in addition to the implant will be removed. In this scenario, if you wish to remain the same size, your replacement implant must be much larger than your initial implant. It becomes evident that breast shape, desired type of implant, and implant pocket positions will all play an integral role in the final design of your breast revision surgery. Breast implant removal of silicone gel implants must always consider the removal of the capsule when silicone molecules have leaked out of the implants. Cohesive silicone gel breast implants are less likely to leak than traditional silicone gel-filled breast implants. The goal of breast implant surgery is to provide enlarged breasts that enhance the appearance of the breasts but in a safe manner. If the breast implant device is too large, it can weigh down on the breast tissues causing the lower pole breast skin to stretch, causing a deformity called bottoming out.
This patient demonstrates the natural appearance of an old breast implant surgery decades ago. Due to her smooth saline implants, she could avoid the commonly seen Snoopy Deformity seen with textured implants. As such, her breasts have naturally sagged as her skin has stretched out from the weight of the implants. If she had undergone breast augmentation with textured implants instead, the implants would not have slid down with the skin, resulting in the irregular appearance resembling a snoopy head when viewed from the side.
Regardless of your prior implant style or size, a breast augmentation revision specialist should be able to correct any irregularities you may present with. However, a revision for aged breast implants, such as our presented patient, is more complex than a traditional breast revision. Increased complexity is due to the added factor involving excess skin. If your surgeon fails to address your sagging skin, you will never achieve your desired breast appearance.
Therefore, revising aged breast implants often includes a simultaneous breast lift. This also brings the importance of implant sizing into the equation. Once you communicate your desired appearance, the surgeon must be able to visualize the resolution of your excess skin and determine which implant size will result in the ideal breast mound for you.