Revision breast augmentation in Fitness Models possess unique challenges to the surgeon. Aesthetic results are usually quite optimal after complete capsulectomy, but the thinning tissue often allows implant visibility or rippling. I often choose to perform complete capsulectomy to allow the breast to re-drape over the implant. It is important for the surgeon to have a thorough knowledge of the previous operations, as implants may have been in prior planes, or neosubpectoral pockets may have been created from prior capsules and have subsequently contracted. I have used the neosubpectoral pocket on many occasions for revision aesthetic breast surgery and have found it useful. However, in women who present with recurrent capsular contracture, it is important to remove the capsules to allow the breast to re-expand and produce an optimal aesthetic shape.
Often in patients who have undergone previous revision aesthetic breast surgery and who are competitive athletes, fitness models, or clothing models, the breast and surrounding subcutaneous tissue is thin. To prevent implant visibility or palpable rippling in this population, I have found Strattice to be quite useful.
The Roxbury Clinic & Surgery Center continues to grow as a center for capsular contracture as well as revision aesthetic breast surgery. An increasing number of women choose to undergo their mastopexy/augmentation, capsular contracture surgery, breast augmentation, removal and replacement, as well as second stage breast reconstruction surgery at the Roxbury Clinic & Surgery Center.
Brian P. Dickinson, M.D.
