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Inframammary Submuscular Breast Augmentation

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This 27 year old had a prior breast augmentation by another surgeon and was dissatisfied.  She had bilateral subglandular augmentation with saline implants.  The right implant was a smooth 330 cc implant overfilled to 390cc.  The left one was a textured 330 cc implant filled to 362cc.  We decided to change to subpectoral gel implants.  She was offered a mastopexy but refused.  Careful measurement showed that the biggest difference between the breast was in the stretch of the lower pole.  During a single procedure, we removed the implants, closed off the subglandular pocket, and replaced the implants with subpectoral Mentor gel 550 cc implants.  She then underwent asymmetric lower pole reduction with inframammary tissue excision.