Sylvia

PROCEDURES

Revision reconstruction to correct implant malposition | Fat grafting

Case Overview

Sylvia is a 44-year-old woman who underwent staged corrective surgery to address severe implant malposition. Prior to this staged set of procedures, Sylvia 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.

Surgeon

Ron Israeli, M.D.

Before

After

Before Stage One Revision

These images show Sylvia’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

Intraoperative

These images show the view from below during her first stage revision surgery with Sylvia 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.

Illustration showing stage one of correcting bilateral implant malposition. The first panel shows low, lateral, and asymmetric reconstructed breasts. The middle panel shows the implants and capsules exposed beneath the chest muscle relative to prior scars. The final panel shows the implants repositioned with internal stitches and dermal matrix to restore proper inframammary fold and symmetry.

Three Months After Stage One Revision Surgery

This is Sylvia 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

Sylvia underwent fat grafting as a planned second stage of her revision surgery. Markings identify persistent hollow areas along the upper breasts above her implants.

Illustration showing stage two of fat grafting to address hollowing in reconstructed breasts. The first panel shows persistent upper breast hollowing above the implants. The middle panel shows fat being harvested from the trunk via liposuction and injected into marked areas. The final panel shows improved breast symmetry, contour, and overall implant-based reconstruction results.

Six Months After Stage One Revision Surgery

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

Last updated on July 15, 2026

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