Case #1487 · Pacific Palisades, CA
Breast Implant Replacement
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This 62-year-old patient from Pacific Palisades, CA had severe capsular contracture on her right breast. Dr. Cassileth performed a bilateral removal and replacement of breast implants with ADM placement.
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
Revision protocol pushes scar work out by 14 days vs. the primary-case schedule.
Revised tissue tolerates active treatment less well than primary cases.
- Skincare
Layered scar protocol, silicone sheeting under tape, daily for 12 weeks.
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 planning starts with the previous result. Existing scars, tissue thickness, and the original technique determine what can be improved and what is locked.
- Surgical plan calibrated against the opposite side. Final shape, scar position, and volume targeted to match, not to a generic ideal.
Pre-op preparation
What to do before surgery. Specific to this case.
- Discontinue blood thinners (NSAIDs, aspirin, fish oil, vitamin E) two weeks out. Acetaminophen remains safe; the full list is reviewed at pre-op.
- Nicotine in any form, cigarettes, vapes, patches, gum, paused six weeks before and six weeks after surgery. Nicotine narrows blood vessels and slows wound healing.
- Arrange button-front or zip-front tops for the first three weeks, overhead reaching is restricted. A drain holder or apron is provided.
- A driver is required the day of surgery and a responsible adult should stay with you the first 24 hours.
- Medical clearance and a current EKG are obtained pre-op. Anesthesia review confirms any chronic-condition adjustments.
Recovery timeline
Milestones specific to this case. Individual recovery varies.
- Day 1–7
Rest, hydration, and short ambulation. Most patients are off prescription pain medication by day 4.
- Week 2
Walking distance doubles. Showering rules relax. Compression garments transition to the long-wear schedule.
- Week 4
Activity ramps slower than average. PT check-in at week 4 anchors the next phase.
- Week 6
Most physical restrictions lift. Return to strength training, full-impact cardio, and overhead lifting.
- Month 3
Tissue softens, scars begin to fade, and overall shape settles toward final. Scar maturation continues for another 6 months.
- Month 6
Revised tissue softens on a longer timeline. Final shape and scar appearance continue to mature through month 12.
