Breast Implant Removal with Mastopexy and Fat Injections, North Carolina*

This 43-year-old woman had placement of subglandular breast implants approximately 18 years ago. As she aged, she became less happy with the outcome. Her breast began to droop and the implants had shifted and became more palpable Her breasts became very unsightly to her. There were also uncomfortable and she wished to have them removed and her breasts lifted without any further breast implant. She was concerned about volume loss so she did request some fat grafting if possible. The patient was very slender and had minimal donor sites however did have some areas which could provide some fat- in her flank and thigh. She underwent explantation of breast implants. She did not know what type of implant she had but they were Siltex 250 cc subglandular devices. She underwent a full mastopexy technique with augmentation of some of the flaps with her own fat, 100 cc per side. Fat was harvested with the Vaser device and power assisted liposuction and processed through the Pure graft system. Explantation with mastopexy can be a very difficult and challenging procedure. Subglandular implants often make mastopexy potentially more dangerous in terms of blood supply to the nipple. Fat grafting is done in a conservative fashion. Over grafting can lead to fat necrosis and abnormalities on mammogram. Most patients having explantation with lifting require a full anchor pattern or inverted T type of incision to allow maximum use of the redundant soft tissue to provide bulk .A