Breast Reduction And Implant Removal Question

The Question

We see a lot of breast augmentations and reductions at Atlantic Coast Aesthetics, so we are familiar with a lot of different requests and desired outcomes, as well as how to achieve them. However, the topic of this week’s Ask Dr. Pane segment is fairly unusual, which is one of the reasons Dr. Pane chose to address this question specifically. The patient asks: “I am 50, 5’1 and avg weight. I have had 34D-36DD natural breasts all my life. Had a reduction/lift in 1992. In my 40’s lost upper pole full and was told another lift wouldn’t do. Had 325cc sc Mentor in 5/15 with lift. Did not provide upper fullness. Replaced 5/16 for 400cc HP Mentor sc. As with my own breasts, both sets of implants went down and out.”

The Case

As often happens, the patient included photos, both before and after, as well as an image that showed the desired outcome. In this case, the patient is aiming for a much smaller bust profile and reduced aureoles, as well as reduction of the scarring if at all possible. In addition, the patient wants to have the entire procedure done in a single session.

Dr. Pane Says:

Based upon the pictures, there is a full-pattern scar along the breast line where the implants were placed. However, the overall condition of the exterior skin does not appear to indicate that the patient’s desired outcome is unattainable, although the scar line may need to be enlarged somewhat due to the nature of the procedure.
To address this issue, Dr. Pane says his preferred method would be to work from the inside out, removing the implant and any abnormal or excess scar capsule within the mammary tissue and then performing a lift and tuck sort of procedure. This would present the smaller profile the patient wants, although it will not do a great deal to revise the scarring which is already present. At best, the scar from the new procedure can be blended into the old one.
Regarding the question of whether the procedures the patient wants can be accomplished in a single session, Dr. Pane says this is absolutely doable, although many of his colleagues would likely disagree. The reason Dr. Pane prefers to perform as many procedures as possible at the same time is to minimize healing time and reduce the likelihood of complications. With this said, a one-stage procedure is always preferable when and where it’s feasible to do so, says Dr. Pane.

Special Considerations

Patients who have undergone previous procedures and later need revision or modification of the original procedure are at a higher risk for post-operative complications. This makes observing sound aftercare practices and keeping in constant contact with the surgeon performing the revision procedure critical to a successful and safe outcome. While complications cannot always be avoided due to the very nature of surgical intervention, compliance with aftercare instructions given by the surgical staff can help greatly reduce the likelihood of their occurrence.
If you have a question about anything related to cosmetic surgery, we at ACA always have the time and interest to discuss your concerns for us. Simply contact us at (561) 422-4116, follow us on Twitter and Facebook or email us at http:///acplasticsurg.com. Your question could be featured in an upcoming Ask Dr. Pane segment, broadcast live in a Google Hangout and answered by Dr. Pane personally. Remember, at ACA we believe the only bad question is the one you don’t ask!

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