Breast Implant Revision & Lift Case 5927

This healthy, athletic 53-year-old woman presented twenty years after subglandular (above-the-muscle) saline implants placed elsewhere. With very little native body fat and thin soft tissue coverage, the implants gradually became visible and distorted over time. She developed significant asymmetry, contour irregularities, ptosis, and severe Baker IV capsular contractures. The breasts were firm, elevated, and “ball-like” in appearance—classic signs of long-standing encapsulation and calcified scar tissue. In patients with thin tissues, placing implants above the muscle often leads to long-term problems. Without adequate coverage, the implant edges show, scar tissue tightens, and the result looks unnatural and feels uncomfortable. The solution required a complete reconstruction, not simply swapping implants. An en bloc capsulectomy was performed to remove the implants and the entire calcified scar capsule together. The old subglandular pockets were eliminated. Smaller, more proportionate silicone implants were selected (175 cc right and 225 cc left) to improve symmetry and create a softer, more athletic contour. The implants were converted to a partial submuscular position for better coverage and long-term stability. Meshed acellular dermal matrix grafts were placed internally to reinforce the pocket and help prevent recurrent contracture. A circumvertical breast lift reshaped the breast envelope and restored proper nipple position. At just eight weeks, her breasts already appear softer, more natural, and balanced, with correction of both hardness and drooping. The result looks like her own anatomy—not like implants. Complex revision surgery is often challenging, but when the foundation is rebuilt correctly, the outcome can be both durable and transformative.