Case #1339 · West Hollywood, CA
Breast Implant Replacement
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This 43-year-old patient from West Hollywood, CA did not want her breast implants anymore and delt like she had outgrown them. Dr. Cassileth performed a bilateral removal of implants with bilateral fat grafting to breasts.
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
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
Scar plan combines silicone sheeting plus topical tape for sustained pressure.
Revised scars respond best to sustained, layered pressure therapy.
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.
- Both sides treated in the same session, symmetric planning, identical tissue handling, and matched final contour are easier to achieve in one operative window than in two.
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.
- No nicotine for 6 weeks before through 6 weeks after surgery. The vascular impact directly affects skin healing.
- Front-closing clothing only for 3 weeks. Drain holders and supportive surgical bras are issued at discharge.
- Confirm a driver for surgery day and a companion who can stay through the first night.
Recovery timeline
Milestones specific to this case. Individual recovery varies.
- Day 1–7
First week is the strictest activity window. Bilateral cases benefit most from staying ahead of swelling with consistent icing and rest.
- Week 2
Walking distance doubles. Showering rules relax. Compression garments transition to the long-wear schedule.
- Week 4
Return to most low-impact activity. Scar massage, compression, and skincare protocols pick up.
- 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.
