Postreduction Breast Augmentation

Abstract

Most breast reduction patients are highly satisfied after surgery. However, there is a subset of women who seek breast augmentation years later to restore lost volume chiefly associated with weight loss and postpartum changes. Breast shape and overall aesthetics are often revised at the same time.

Methods: A retrospective review was performed of 2 surgeons' experiences with post-reduction breast augmentation. Twenty patients were identified between 2002 and 2014. An in-depth chart review was conducted to determine patient motivation and to examine the operative techniques employed. Implant variables, a reduction specimen weight to implant volume comparison (where available), and complications are reported.

Results: The average age was 37.1 years and average body mass index was 21.8 kg/m(2). Most patients waited over a decade to have their breasts revised. Weight loss was the motivating factor in 8 patients and pregnancy changes in 11. Nineteen patients wished to stay with the same bra size or 1 cup size larger. Although all patients elected to have an implant placed, 19 patients wished to have an improved breast shape, not specifically a larger volume. The average breast implant was 203.5 cm(3) (range, 120-340 cm(3)). Complications from implant placement included a seroma treated by aspiration and a Baker class III capsular contracture that required surgical correction.

Conclusions: A small subset of reduction mammaplasty patients seek breast augmentation many years later primarily to improve breast contour, not to restore their prereduction breast volumes. Conservative augmentation combined with revision of breast shape and areolar aesthetics yields good results with minimal complications.

Fig. 1.

A 42-year-old woman with a BMI of 22 is shown before (A, B) and after (C, D) placement of 150-cm³ implants 18 years after her initial inverted-T reduction. Both an areolar and lower pole shape revision were performed at the same time.

Fig. 2.

A 41-year-old woman with a BMI of 21 is shown before (A, B) and after (C, D) placement of 340-cm³ implants (the largest in the series) 15 years after her initial inverted-T reduction. An areolar shape revision on the right side was performed at the same time.