Patient - Breast Augmentation

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This 72 year old lady presented with a complicated breast history. She had saline implants placed in 1976. These leaked and were replaced in 1980 with gel implants. These also leaked and were replaced in 1996 with another set of saline implants. This last set were McGhan textured, anatomically shaped implants. She said the left breast was hard from the first. Both breasts were now very hard and the left was intermittently painful. I offered her options, including straight implant removal without replacement but she did not want to go without implants. I therefore recommended removal with total capsulectomies (removal of the scar around them) and new, smooth gel implants.

Breast Augmentation - Dr. Richard Bosshardt
Breast Augmentation - Dr. Richard Bosshardt


She is shown 6 months after surgery. Her implants were intact but the capsules were severely calcified, a common finding with these old implants. The capsules were removed completely (the term en bloc is sometimes used), were carefully checked, and were entirely benign. Her new implants are Allergan Natrelle Inspira Style SRM smooth, round gel implants. The left is 200 cc. The right is 240 cc. Her breasts are very soft. They look and feel very natural. She is delighted and so am I. I expect these to last her the rest of her life. Despite her complex history and my findings, she was in excellent health and her only issues were some osteoarthritis and esophageal reflux. 

Breast Augmentation - Dr. Richard Bosshardt
Breast Augmentation - Dr. Richard Bosshardt
Breast Augmentation - Dr. Richard Bosshardt

You can see how different the two capsules are from the same patient. The left side, which was always the hard side, has a capsule so severely calcified that it is rigid and brittle. The left capsule is slightly thickened but otherwise unremarkable. Other than slight yellowing, her implants look fine. The saline in them was clear. 

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