Case #1475 · Marina Del Rey, CA
Breast Implant Replacement
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This 63-year-old patient from Marina Del Rey, CA has a history of severe capsular contracture and ruptured breasts implants. Dr. Cassileth performed bilateral implant removal and replacement, full capsulectomy, pectoralis muscle r
Continued care
Recommended aftercare, skincare, and MedSpa services for Breast Implant Replacement.
- Compression bra continuously for 4 weeks
- No upper-body resistance training for 6 weeks
- Scar management at 3 weeks if existing scar is revised
- Hyperbaric oxygen therapy when recommended for revision cases
- Medical-grade silicone sheeting on the inframammary incision
- SkinCeuticals C E Ferulic for scar healing
- SPF 50+ on incisions for 12 months
- Laser or microneedling for scar refinement after 3 months
- LED light therapy for swelling reduction
- Indiba radiofrequency for tissue recovery
- Aftercare
Bilateral HBOT protocol, 10–15 sessions over the first 6 weeks.
Bilateral procedures heal more reliably with sustained HBOT.
- Aftercare
Tissue rest extended by 2 weeks before scar treatments begin.
Revised tissue tolerates active treatment less well than primary cases.
- Skincare
Extended scar protocol (silicone + paper-tape compression) runs through month 3.
Revised scars respond best to sustained, layered pressure therapy.
- Aftercare
Mobility ramp slowed; physical therapy consultation at week 4.
Older patients benefit from a guided return-to-activity plan.
Why this approach
The decisions that shaped this surgical plan.
- Revision case, prior tissue patterns, scar locations, and anatomical changes from the first procedure all factored into the surgical plan.
- Bilateral approach chosen to keep the planning, the tissue response, and the aesthetic outcome consistent between sides.
Pre-op preparation
What to do before surgery. Specific to this case.
- Stop NSAIDs, aspirin, and high-dose fish oil two weeks before surgery; the surgical team provides a full medication list at the pre-op visit.
- Full nicotine cessation 6 weeks pre- and post-op. This includes vapes and nicotine replacement products; the constriction effect is the same.
- No overhead clothing for 3 weeks. Stock front-zip tops, supportive sports bras (post-clearance), and the drain pouches we provide.
- A driver is required the day of surgery and a responsible adult should stay with you the first 24 hours.
- Internal medicine sign-off, and cardiac workup when indicated, completes a few weeks before the surgical date.
Recovery timeline
Milestones specific to this case. Individual recovery varies.
- Day 1–7
Both sides healing in parallel means the early phase is quieter, short walks, full rest periods, and no driving until off pain medication.
- Week 2
Patients off prescription pain medication, walking 1–2 miles daily, and back to most light household activity.
- Week 4
Older patients benefit from a guided plan here, PT consult, gradual activity, and stretch goals through week 8.
- Week 6
Standard clearance milestone. Patients return to most exercise, gym work, and sleeping in any position.
- Month 3
Most patients consider this the "final result emerges" milestone. The remaining 10 percent of refinement plays out through month 6.
- Month 6
Final shape continues to settle. Revised areas commonly look their best between months 9 and 12.
