Case #1489 · Los Angeles, CA
Breast Implant Replacement
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This 26-year-old patient from Los Angeles, CA had capsular contracture and asymmetry of breast implants. Dr. Cassileth performed a breast implant removal and replacement with an internal lift. She loves her smaller breasts and is thankful to no longer
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.
- Skincare
Sun avoidance and SPF protocol extended through month 12 to minimize scar hyperpigmentation.
Younger skin pigments scars more reliably under sun exposure.
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.
Pre-op preparation
What to do before surgery. Specific to this case.
- Aspirin, ibuprofen, vitamin E, and fish oil discontinued 14 days pre-op to reduce bruising risk. Acetaminophen is allowed.
- 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.
- Front-closing clothing only for 3 weeks. Drain holders and supportive surgical bras are issued at discharge.
- Day-of transport and an overnight companion (24 hours minimum) are required for discharge.
Recovery timeline
Milestones specific to this case. Individual recovery varies.
- Day 1–7
Short walks every couple of hours, no lifting over 5 lb, and full nights of rest. The worst of the swelling peaks around day 3.
- Week 2
Activity ramps up cautiously: longer walks, no lifting yet. Most patients return to desk work this week.
- Week 4
Light cardio and most desk-work activities cleared. Lifting limit increases to 15 lb. Scar massage typically starts now.
- Week 6
The "back to normal" week for most patients. Final compression schedule transitions to optional.
- Month 3
Shape is 80–90 percent of final. Scars are still pink and will continue to lighten through month 12.
- Month 6
Slower maturation than primary cases, revision tissue keeps refining well past month 6.
