41-year-old multiparous female s/p breast augmentation 2004 by another plastic surgeon with subpectoral saline breast implants. Ten years later, she developed rupture of the right breast saline implant, bilateral capsular contractures and significant breast asymmetry. She presented to Dr. Petti and requested implant removal with no replacement. A year later after implant removal, she returned and requested to proceed with another breast augmentation. She was not able to accept the breasts without implants as she had empty breasts with folds and irregularities since the D-cup implants placed in 2004 significantly and permanently stretched her breast skin as well as nursing 3 children. Dr. Petti performed the second breast augmentation and placed the implants submammary to fill out the “skin brassiere” of the breasts, as the patient did not want the scars associated with a breast lift at the time of the second breast augmentation. She performed modification and control of the new submammary breast pocket with her customized suture technique of creating an “internal bra”. The newly created pocket by Dr. Petti restored cleavage, upper pole and outer pole fullness to the breast shape and filled in the folds of the breast that were present from the removal a year ago. It was a complex surgery and this is her outcome at 2 months. Her breasts are soft and natural. The patient is happy she did not need a breast lift.
