About changing breast prostheses: description of a clinical case

Breast augmentation is very often performed using round prostheses. The route of insertion (through the armpits, the nipple or the fold under the breast) varies according to the surgeon’s habits and beliefs, the patient’s requests and her past history.

I believe that the procedure should be carried out as often as possible using anatomical implants under the breast (invisible scar below the breast). Anatomical prostheses give a much more natural appearance than round ones, and the size can be adapted to the patient’s measurements, making them a choice procedure in the therapeutic arsenal for improving the overall figure.

In my opinion, round prostheses should no longer be offered via the axillary route (scar in the armpit) for a number of reasons, but in particular because the prostheses tend, over time, to move upwards and outwards under the contractions of the muscle under which they are positioned.

Here is an illustration of this problem, which I come across quite frequently in my day-to-day practice.

Clinical history:

The patient was operated on by a renowned surgeon who frequently performs breast augmentation with round implants via the axilla. When her implants moved into the armpit, she was operated on again by another surgeon, using the same technique. The patient was dissatisfied with the result and asked me for a solution to improve the shape of her breasts.


The round prostheses were removed through a scar under the breast and anatomical prostheses were inserted.


Round implants give the breast an unnatural shape. The fact that they are inserted through the armpit under the muscle means that the surgeon has to leave a path for the prostheses to pass through to the armpit. The prostheses rise with time and are too high for breasts that tend to fall over time.
Not only must the prostheses be lowered, but anatomical prostheses must also be used to give the lower part of the breast more shape. This solution restores the natural shape of the breast and helps to reduce, if not completely eliminate, breast ptosis (sagging breasts).


The right prosthesis is clearly too high. The position and shape of the prosthesis increases the drooping appearance of the breasts.

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