Revision reconstruction to correct implant malposition | Fat grafting

Case Overview

Kathleen is a 44-year-old woman who underwent staged corrective surgery to address severe implant malposition. Prior to this staged set of procedures, Kathleen had bilateral mastectomies with staged, tissue expander implant breast reconstruction. One year later, she was unhappy with the outcome of her breast reconstruction and presented for second opinion evaluation.
Dr. Israeli


Ron Israeli, M.D.

before revision
after revision
Before Stage One Revision
These images show Kathleen’s breast reconstruction before her first revision surgery. Her breast implants are low, lateral, and asymmetrical. The severe implant malposition left her with chronic discomfort and an unsatisfactory aesthetic outcome. Her mastectomy scars are visible on her lower breast skin. She has mild animation of her implants due to their subpectoral position, but this does not bother her.
Preoperative Markings
Preoperative markings identify how high the inframammary (lower breast) folds need to be raised. This is best demonstrated when she raises her arms.
During Stage One Revision Surgery
These images show the view from below during her first stage revision surgery with Kathleen laying flat  before and immediately after correcting her implant malposition. 

The new fold under her breast was repaired with internal stitches reinforced with a dermal matrix and the capsule surrounding her implants. You can learn more about this implant revision technique here.


Three Months After Stage One Revision Surgery

This is Kathleen three months after bilateral revision reconstruction to correct the implant position. Her new implants are now better supported following internal capsular repair reinforced with dermal matrix.
Before Stage Two Revision Surgery
Markings for Fat Grafting
Kathleen underwent fat grafting as a planned second stage of her revision surgery. Markings identify persistent hollow areas along the upper breasts above her implants.

Six Months After Stage One Revision Surgery

These images show Kathleen six months after her first stage revision reconstruction surgery to correct implant malposition. Two stages were required to get to this point. Kathleen is now more comfortable with her reconstruction as her implants are better supported with improved contour.