Revision breast augmentation typically requires techniques similar to those used in reconstructive breast surgery to achieve the most natural contour and highest level of symmetry possible, as suggested by leading Beverly Hills plastic surgeon Dr. Tarick Smiley.
For this reason, breast augmentation reconstruction requires higher level of technical skills (and experience) on the surgeon’s part to achieve good results from the surgery, Dr. Smiley said.
The celebrity plastic surgeon has recently posted a case study on his Snapchat account involving a patient who had breast augmentation 10 years ago and was seeking revision to correct several aesthetic-related problems, which the surgeon has enumerated in the video.
- Enlarged areola
- Visible rippling along the mid cleavage
- Too much cleavage (the breasts were too far apart)
- Excessive lateral bulge
- Sagging or bottomed-out implants
Dr. Smiley first started with the areola reduction in which he used a cookie-cutter device to delineate the new areola and make it smaller. The scar from this technique goes precisely at the dark-light skin junction so it will blend nicely to the background.
To correct the sagging appearance, he made vertical incisions from the areola down to the submammary fold, and another incision pattern that goes parallel to the breast crease. (Basically, this is an anchor breast lift technique due to the shape of its final scar, which is expected to fade into the background about a year postop.)
The anchor breast lift allowed Dr. Smiley to remove some loose skin and tighten and elevate the breast tissue, leading to a perkier appearance.
To further achieve good breast shape and to correct the excessive lateral bulge, he repaired the breast pocket (by making it smaller) and so the implant will not migrate.
Meanwhile, he addressed the visible rippling by replacing the old saline implants, which have a natural deflation rate of 1 percent per year due to evaporation. And since the patient had hers for 10 years, the implants had already lost about 10 percent of their volume, and thus resulting in rippling.
Oftentimes, silicone implants are considered as good replacements if the patient wants to prevent or correct rippling and palpability since they have no deflation rate and they are filled with a cohesive medical-grade silicone gel that resembles that of the breast tissue and fat.