The patient is a 42 year old woman who had breast augmentation many years ago with saline implants that were placed above the pectoralis muscle. She had no problems from her surgery but reported that the right breast was always firmer than the left, even since shortly after her procedure. Over time, her breasts began to droop. She noted that the skin over the implant became thin and was concerned that the implant might eventually erode through the skin. Sagging was also having an effect on the shape and location of her nipple and areola.
A few years ago, the patient began to notice that the right breast became more firm and described it as “rock hard”. There was intermittent breast pain, especially with direct pressure and the difference in the shape and level of the breasts were difficult to hide with clothing or a bathing suit. She was embarrassed to hug anyone because of the firmness and pain. The patient also noticed that when she lay down, the left breast implant fell to the side which felt “weird”.
She felt she was a C and mostly liked her size but wanted to be a small C if possible. The patient was also bothered by the shape of the upper poles of her breast which had a sharp cutoff and looked like a breast implant. The patient had saved the breast implant information card from her prior surgery which documented that she had 330 cc. saline breast implants.
