8576

This patient came to The Piazza Center ready to update a breast augmentation she'd had more than twenty years earlier. Her original saline implants had begun to sit too high on the chest, leaving a rounded upper pole, limited fullness below, and a shape that no longer matched how she wanted to look. Her goals were specific: something softer and more natural, better lower pole fullness, and improved cleavage — while still keeping real separation between the breasts rather than a crowded look. Dr. Piazza approached the revision in three parts. The aged saline implants were exchanged for 450cc Natrelle Inspira SoftTouch full projection silicone gel implants, chosen for their softer feel and more natural drape. A GalaFLEX internal support matrix was then placed to reinforce the lower pole and hold the new implant position — an internal scaffold that supports the tissue while the body builds its own collagen framework around it. Finally, autologous fat harvested from the groin and outer thighs was grafted along the medial breast (60cc right, 62cc left) to soften the transition at the cleavage and smooth the contour edges that thinner tissue can reveal after two decades with implants. The combination accomplished what none of the three could alone: the implant exchange addressed volume and feel, GalaFLEX addressed position, and fat grafting addressed contour. Total surgical time was approximately two hours. The result is a breast that sits lower and more naturally on the chest, with fullness where she wanted it and a refreshed silhouette that still looks like her. Individual results vary.