Breast implant removal with smaller replacement can pose some challenges such as risk of sagging appearance and poor breast contour, although with close attention to details great results can be achieved.
Recently, leading Los Angeles plastic surgeon Dr. Tarick Smiley has performed a surgery on a woman with 500 cc silicone implants who wanted them replaced with 270 cc, which could slash her breast size by almost half.
Due to the significant downsize, she was deemed as a good candidate for a simultaneous breast lift. Without this procedure, her implants would settle too low, resulting in a drooping appearance and deflated-looking upper breast pole.
To remove the old implants along with their scar capsule, Dr. Smiley created a small incision within the breast crease (submammary fold), which would result in a well-concealed scar. He then replaced them with a new pair of smaller implants.
Next, he performed a standard breast lift in which the incision pattern ran around the areola, which was extended downward towards the crease and then across the base of the breast. This would result in an inverted T or anchor-shaped scar that is expected to blend into the background 1-2 years postop.
For long-lasting effects, breast lift should not just be about skin tightening and resection. After all, its elasticity makes it susceptible to the effects of gravity and aging. Hence, the celebrity plastic surgeon creates a more resilient support by remodeling the deeper tissue.
The use of “deep tissue work,” according to Dr. Smiley, also allows the surgeons to elevate some of the tissue of the lower breast pole, resulting in additional upper pole fullness. According to studies, the most preferred breast shape has a 45:55 upper to lower pole ratio (resembling a teardrop shape).
To further promote youthful and natural-looking results, the new position of the nipples should be horizontally and vertically aligned with each other.
Furthermore, tightening the deeper tissue allows the skin to receive no or very minimal tension, which is the key to good healing and “nice looking scars,” says Dr. Smiley.