Major Breast Revision: Implant Exchange with Capsulectomy and Mastopexy-N.C.*

Changes with breast implants over time occur frequently. Patients with sub glandular breast implants have a higher chance of developing capsular contracture and therefore often require implant exchange with removal of capsules. It is recommended that the new implants be placed in a new location typically in the submuscular or a partial sub-pectoral location. More recently biological meshes or synthetic mesh have been used in these types of cases. This 65-year-old woman had breast implants since 1984. She had them exchanged due to rupture about 15 years prior to this procedure and the implants were in the subglandular space. She had weight loss and obvious aging and development off breast ptosis . The implants became quite distorted and developed encapsulation. Dr. Lyle performed bilateral implant exchange with total capsulectomy and site change to positioning in the submuscular pocket. He utilize the de-epithelialized breast flaps from the mastopexy to provide inferior support. The patient had similar size breast implants replaced -Mentor moderate plus silicone with mastopexy. Because she had lost significant amount of weight, she elected abdominoplasty done at the same time. Her final result was a much more natural appearing breast and a flatter abdomen with removal of loose skin. This type of case is quite challenging and requires experience ,expertise and skill in revisional surgery.