Augmentation - Leaking Implant

This 32 year old is seen 20 months after transumbilical augmentation with a leaking right implant in the preoperative pictures.  Her preoperative pictures show that her right breast is smaller.  The umbilical (belly button) scar is not visible.  At the time of her original TUBA, 390 mL saline inflatable implants were used and the fill volumes were 390 mL on both sides.  Her right implant was replaced with an identical implant filled to 390 mL at the time of this procedure.  The leaking implant was found to have a small linear defect of the implant shell.   The right capsule was opened around the edge (peripheral capsulotomy) to accomodate the new implant.  Her postoperative pictures were taken 3 weeks after this procedure and her periareolar incision has healed nicely.  Commonly, an implant will be leaking for a few months before the change in size is noticed by the patient as the leak is very slow.  During this time the capsule will contract as the implant size decreases.  The capsule then needs to be opened again (peripheral capsulotomy) to provide the correct space for the replacement implant.  This procedure typically has a rapid, relatively painless recovery.  It is completely different from a primary/original augmentation procedure.  Usually, either the standard manufacturer's warranty or the ehanced warranty will help cover the cost of this procedure.  With this patient, a periareolar incision was used to remove the leaking implant and insert the new saline implant.  It is not possible to go back through the belly button if an implant needs to be replaced.  Periareolar, axillary(underarm) and inframammary (under the breast) are the three available choices for placement of the incision.