Breast Augmentation Patient # 4
52 yo woman, 5’4"tall, weight 114 pounds who had subglandular breast augmentation with 270cc silicone gel-filled breast implants through a periareolar incision in December 1987. She was treated for left capsular contracture with an open capsulotomy in March 1988, and required evacuation of a hematoma the following day. She was later treated with a right closed capsulotomy in January 1990. She presented to our practice 16 years later with concerns regarding breast asymmetry and mild breast discomfort. Bra size at that time was 34C-cup. Examination showed asymmetry of breast size and shape. The right breast was globular (grade IV capsular contracture) and laterally displaced with the nipple-areolar complex positioned too high on the breast mound. The left breast had loss of upper fullness and grade III capsular contracture. The right nipple was 1.5cm higher than the left nipple. The overlying soft tissue coverage was thin. Contraction of the pectoralis muscles enhanced the visibility of the subglandular placement and capsular contractures. MRI demonstrated bilateral implant rupture with a small amount of extracapsular silicone on the right. Eight month post-operative photographs show the results following removal of both ruptured implants with complete capsulectomy, removal of right extracapsular silicone gel, elevation of the right inframammary fold, site change to the subpectoral position with closure of the subglandular spaces, augmentation with Mentor Lumera textured, contoured, high profile (345cc) silicone gel-filled breast implants, and a right crescent inferior periareolar mastopexy. Post-operative bra size is a 34C-cup.