Breast Revision with Mastopexy and Ideal Implants*

This 58-year-old woman had bilateral subglandular textured saline implants placed over 10 years ago. These were the 360 cc devices. She did not like the palpability of the implants and developed ptosis and desired exchange of her implants with downsizing and mastopexy. Dr. Lyle performed an implant exchange; because the patient had subglandular implants he decided upon site change to a submuscular plane to reduce palpability and reduce capsular contracture. The patient also changed to the Ideal implant which is a structured saline device with less palpability than standard saline devices. She had simultaneous mastopexy performed in one stage. She had her 360 cc devices downsized to 245 cc devices. She was very happy with her outcome with somewhat smaller breasts and a lifted appearance with much less palpability. Her textured devices are no longer being manufactured although the patient did not have any signs of ALCL intraoperatively. Recent recall of some textured devices has prompted many woman to elect to remove their implants. Site change from a sub-glandular pocket to a submuscular pocket is recommended to reduce palpability and is a more favorable environment to reduce risk of capsular contracture. This is a more difficult procedure. It requires capsulectomy and the establishment of a subpectoral pocket and sometimes soft tissue reinforcement. The benefits are apparent with less palpability and a natural appearing breast in most instances.