The office of Dr. Sarah Elswick and the Aesthetic Injection Practice in Troy Michigan
Breast Gallery
These are photos of our actual patients. We believe in showing both patients with excellent outcomes but also patients with realistic outcomes.
Looking critically at before and after photos is an essential part of preparing for your surgical procedure. Things to note are the patient’s age, weight, and overall body shape to try to find someone who is comparable to you. It is important to note that it takes at least 6-12 months to see the final results of most surgical procedures (almost every patient looks good while lying down on the OR table)! While we try to provide long term results, this is not always possible.
These are photos of our actual patients. We believe in showing both patients with excellent outcomes but also patients with realistic outcomes. We also want to show you what the scars look like. Not every surgeon has this philosophy but we value honesty and want to ensure that you have realistic expectations prior to proceeding with surgery. The only editing that has been done is to remove potentially identifying features (such as jewelry and tattoos), cropping/re-sizing, and adjusting the overall lighting. Consider all these factors when comparing our photos to those of other surgeons.
Breast Augmentation
Breast Augmentation with Implant
Case-135-Breast-Augmentation
This is a patient in her 40s who wanted to increase the volume of her breasts after having children. She was a A-B cup prior to surgery. She underwent a total submuscular breast augmentation with Sientra smooth round low plus with a 300 cc on the right and a 335 cc on the left silicone implants. She is now a C cup.
Case 2- Breast Augmentation
This is a patient in her 30s who wanted more proportionate breasts. She lost volume in her breasts after children and breastfeeding and felt as if her breasts and nipples appeared “sad.” She was an A cup prior to her breast augmentation. She underwent a bilateral total submuscular breast augmentation with Mentor smooth round high profile 400 cc silicone implants. She is very happy with the restored fullness of her breasts.
Case 105- Breast Augmentation
This is a patient in her 40s who had been thinking about having a breast augmentation for years. She was a 34 A cup prior to surgery and wanted to be a B cup afterwards. She underwent a total submuscular (under the muscle) breast augmentation with Sientra smooth round low profile implants (190 cc on the right side and 220 cc on the left side). She is extremely happy with her natural results!
Case 71- Breast Augmentation
This is a patient in her 30s who wanted improved volume in her breasts after experiencing deflation in her breasts from pregnancy and subsequent weight loss. She was a 32B cup prior to surgery. She underwent a total submuscular breast augmentation through inframammary fold incisions with Sientra smooth round moderate plus profile 385 cc implants.Dr. Sarah M. Elswick
Case 6- Breast Augmentation
This is a patient in her 20s who wanted improved volume in her cleavage area. She underwent a dual plane (submuscular) breast augmentation through inframammary fold incisions with Sientra smooth round silicone 400 cc low profile implants.Dr. Sarah M. Elswick
Case 5- Breast Augmentation
This is a patient in her 50s who experienced significant changes in her body after undergoing menopause. She wanted her breasts to be better proportioned with the rest of her body. She underwent a dual plane (submuscular) breast augmentation through inframammary fold incisions with Mentor round silicone 350 cc moderate plus implants.Dr. Sarah M. Elswick
Case 3- Breast Augmentation
This is a patient in her 50s who wanted improvement in the volume of her breasts and removal of excess fat in the armpit area. She underwent a subglandular breast augmentation through inframammary fold incisions with Mentor round silicone 375 cc high profile implants. The patient also had liposuction of the armpit area. A total of 50 cc of fat was removed from each side.Dr. Sarah M. Elswick
Breast Augmentation Revision
Case 116- Breast Augmentation Revision
This is a patient in her 30s who underwent a breast augmentation 14 years prior with another surgeon. She had submuscular saline implants placed. She thought her implants were too large and heavy. on both sides to bring her implants up and in and decrease the size slightly. She had Allergan Natrelle style 168 (moderate profile) saline implants in place, filled to 650 cc on the right and 700 cc on the left. The patient underwent a bilateral breast augmentation revision, with removal of her old implants, pocket revision (capsulotomies and capsulorrhaphies), Galaflex mesh placement, bilateral mastopexy (Wise pattern on the right and vertical on the left) and placement of new, slightly smaller implants (Allergan SCX 615 on the right and 650 on the left).
Case 155 - Breast Augmentation Revision
The patient is s/p bilateral total capsulectomy with removal of ruptured silicone implants, bilateral implant replacement, and bilateral pocket revision with conversion from a total submuscular to a dual plane 1 breast augmentation, right lateral chest wall plication and elevation of the inframammary fold, and limited left superolateral chest wall plication on 2/8/2024. The patient has a Sientra HSC low plus smooth round silicone 225 cc implant on the right side and a 255 cc implant on the left side!
Case 32- Breast Augmentation Revision
This is a patient in her 30s who underwent a submuscular breast augmentation with Mentor silicone 375 cc moderate plus profile implants and fat grafting to the breasts by another surgeon approximately 7 months previously. She was unhappy with the droopiness of the breast as well as the areola size. She underwent a pocket revision to open the implant pocket in the cleavage area and to close down the outer aspect of the implant pocket in addition to bilateral vertical mastopexies (lift). The same implant and pocket location were utilized.Dr. Sarah M. Elswick
Case 19- Breast Augmentation Revision
This is a patient in her 20s who underwent a breast augmentation approximately 2 years prior. She had bilateral subglandular (above the muscle) breast augmentation with Natrelle smooth round moderate profile implants (330 cc on the right and 310 cc on the left) via inframammary fold incisions by another surgeon. Over time she notes that her implants dropped. She also wanted to be slightly larger. The patient underwent a bilateral breast augmentation revision, with removal of her old implants, plane change (moving the implants from above the muscle to under the muscle), and placement of new, larger implants. She now has Mentor round moderate plus profile 450 cc implants.Dr. Sarah M. Elswick
Case 41- Breast Augmentation Revision
This is a patient in her 30s who underwent a breast augmentation 15 years prior. She has had multiple revisions and a breast lift elsewhere. She noticed that the breasts changed with having children. She sustained a rupture of her left breast implant and desired a revision of her breast augmentation on both sides to bring her implants up and in and decrease the size slightly. She had Allergan Naturelle style 168 (moderate profile) saline implants in place, filled to 650 cc on the right and 700 cc on the left. The patient underwent a bilateral breast augmentation revision, with removal of her old implants, pocket revision (capsulotomies and capsulorrhaphies), Galaflex mesh placement, bilateral mastopexy (Wise pattern on the right and vertical on the left) and placement of new, slightly smaller implants (Allergan SCX 615 on the right and 650 on the left).Dr. Sarah M. Elswick
Case 33- Breast Augmentation Revision
This is a patient in her 50s with a history of a sub muscular breast augmentation with saline implants approximately 15 years prior performed by another surgeon. Her old implants were high profile saline implants filled to about 500 cc. She was interested in having smaller implants and perkier breasts. She underwent a bilateral implant exchange to Mentor round silicone 350 cc moderate plus profile implants. Prior to placing the implant, the pocket where the implant was located was revised to help the implant sit in the proper position. This involved opening the pocket in cleavage area and using sutures to close down the outside of the pocket. The revision was completed with a vertical mastopexy (lift) with autoaugmentation.Dr. Sarah M. Elswick
Case 41- Breast Augmentation Revision
This is a patient in her 30s who underwent a breast augmentation 15 years prior. She has had multiple revisions and a breast lift elsewhere. She noticed that the breasts changed with having children. She sustained a rupture of her left breast implant and desired a revision of her breast augmentation on both sides to bring her implants up and in and decrease the size slightly. She had Allergan Naturelle style 168 (moderate profile) saline implants in place, filled to 650 cc on the right and 700 cc on the left. The patient underwent a bilateral breast augmentation revision, with removal of her old implants, pocket revision (capsulotomies and capsulorrhaphies), Galaflex mesh placement, bilateral mastopexy (Wise pattern on the right and vertical on the left) and placement of new, slightly smaller implants (Allergan SCX 615 on the right and 650 on the left).Dr. Sarah M. Elswick
Case 17- Breast Augmentation Revision
This is a patient and her 40s who underwent a breast augmentation approximately 20 years prior after her breasts became deflated from pregnancy. She had submuscular saline implants filled to 325 mL placed via periareolar incisions, which had been performed by another surgeon. Almost immediately after surgery, she wished she had gone larger. The patient underwent a bilateral breast augmentation revision, with removal of her old implants and placement of new implants. A pocket revision was also performed, opening the capsule in the cleavage area and closing it down along the outer aspect with sutures (like an internal bra). She has Mentor round moderate profile 350 cc saline implants filled to 425 cc.Dr. Sarah M. Elswick
Breast Augmentation with Lift (Augmentation Mastopexy)
Case 18- Breast Augmentation Mastopexy
This is a patient in her 40s who wanted to increase the volume of her breasts and improve the droopiness. She was a small B cup prior to surgery after losing some weight. She underwent a total submuscular breast augmentation with a breast lift through Wise pattern (anchor) incisions with Sientra moderate plus 355 cc implants. She thinks that her breasts are “perfect” after surgery.Case 41- Breast Augmentation Revision
This is a patient in her 30s who underwent a breast augmentation 15 years prior. She has had multiple revisions and a breast lift elsewhere. She noticed that the breasts changed with having children. She sustained a rupture of her left breast implant and desired a revision of her breast augmentation on both sides to bring her implants up and in and decrease the size slightly. She had Allergan Naturelle style 168 (moderate profile) saline implants in place, filled to 650 cc on the right and 700 cc on the left. The patient underwent a bilateral breast augmentation revision, with removal of her old implants, pocket revision (capsulotomies and capsulorrhaphies), Galaflex mesh placement, bilateral mastopexy (Wise pattern on the right and vertical on the left) and placement of new, slightly smaller implants (Allergan SCX 615 on the right and 650 on the left).Dr. Sarah M. Elswick
Case 33- Breast Augmentation Revision
This is a patient in her 50s with a history of a sub muscular breast augmentation with saline implants approximately 15 years prior performed by another surgeon. Her old implants were high profile saline implants filled to about 500 cc. She was interested in having smaller implants and perkier breasts. She underwent a bilateral implant exchange to Mentor round silicone 350 cc moderate plus profile implants. Prior to placing the implant, the pocket where the implant was located was revised to help the implant sit in the proper position. This involved opening the pocket in cleavage area and using sutures to close down the outside of the pocket. The revision was completed with a vertical mastopexy (lift) with autoaugmentation.Dr. Sarah M. Elswick
Case 1- Breast Augmentation Mastopexy
This is a patient in her 20s who was dissatisfied with the volume and appearance of her breasts after pregnancy and 80 pound weight loss. She underwent a dual plane (submuscular) breast augmentation through inframmmary fold incisions with Mentor 500 cc high profile implants.Dr. Sarah M. Elswick
Breast Lift (Mastopexy)
Case 166 - Breast Lift
Breast Lift (Mastopexy) and Fat Transfer to the Breasts. This is a patient in her 20’s who didn’t like the droopiness of her breasts after massive weight loss. She also wanted slightly larger breasts and had extra fat in her lower abdomen. She underwent a bilateral breast lift (Wise pattern with auto-augmentation) with Galaflex mesh placement, a dissolvable mesh which helps to hold the breast shape over time. She also underwent fat transfer to the breasts, injecting 67 cc to the right breast and 80 cc to the left breast, focusing on the upper inner breasts.Dr. Sarah M. Elswick
Case 175-Breast-Reconstruction
Breast Reconstruction: Right Direct-to-Implant with Breast Lift (Mastopexy) and Left Breast Reduction. This is a patient in her 40’s who was diagnosed with right breast cancer. She was a DD cup prior to her reconstruction and was not concerned about her size after reconstruction. She underwent a right skin-sparing mastectomy with direct-to-implant reconstruction. She had a Sientra smooth moderate plus 650 cc silicone implant with GalaFLEX mesh placed above the muscle (pre-pectoral) on the right side. The breast lift was done through Wise pattern (anchor) incisions. A breast reduction was also performed on the left side with removal of 197 g (0.43 lb) of tissue to help achieve symmetry. She underwent chemotherapy and required radiation to the right breast after surgery.
Case 40- Breast Implant Removal and Mastopexy
This is a patient in her 40s who had a breast augmentation 20 years prior. She developed capsular contracture of her breast implants. She underwent multiple revisions to treat the capsular contracture elsewhere but kept having recurrences. She had 600 cc silicone implants in place above the muscle and was a DDD cup. She underwent removal of the implants, capsulectomies (removing the hardened capsules around the implant), a breast lift with auto-augmentation (rearranging the patient’s own breast tissue to improve the volume of the breasts in the cleavage area), and inverted nipple repair. Her breasts are soft, natural, and no longer painful. She feels like a woman again!Dr. Sarah M. Elswick
Case 123- Breast Lift
This is a patient in her 30s who had multiple concerns about her breasts. She thought her breasts were deflated and she had asymmetry with the left breast being larger than the right breast. She also had excess skin of the breasts after loosing 50 pounds. She is a 32 DD. She underwent a breast lift with auto-augmentation (rearranging the patient’s own breast tissue to improve the volume of the breasts in the cleavage area).Dr. Sarah M. Elswick
Case 72- Breast Lift
This is a patient in her 40s who underwent a breast augmentation 7 years prior with Mentor smooth round moderate plus 350 cc implants placed via periareolar incisions in the submuscular plane with another surgeon. She thought she was done having children, but decided to have more after her breast augmentation. She also breast-fed and lost a lot of weight after the pregnancy. She is currently a D/DD. She thought that her breasts were too large and sat low on her chest. The patient underwent a bilateral mastopexy (vertical technique) and Galaflex mesh placement. The Galaflex mesh acts like a hammock in the lower part of the breast to hold up and reinforce the tissue. The patient is ecstatic with her results!Dr. Sarah M. Elswick
Case 10- Breast Lift
This is a patient in her 70s who was bothered by the appearance of her droopy breasts and extra skin. She was happy with the size of her breasts. She underwent a bilateral vertical mastopexy (breast lift) with autoaugmentation, which involves rotating some of the breast tissue from the lower breast to the cleavage area. Doing an autoaugmentation not only moves the breast tissue to a more desirable location but also helps the lift last longer.Dr. Sarah M. Elswick
Case 73- Breast Implant Removal, Mastopexy, and Fat Transfer
This is a patient in her 40’s who underwent a breast augmentation in her 20’s with another surgeon. She had recalled McGhan textured teardrop 380 cc saline implants in place under the muscle. Subsequent to this she had children, breastfed, and gained some weight. Prior to her augmentation she was a B cup. Recently she developed pain in her breasts. On exam, she was found to have capsular contracture, which is hardening of the capsules that naturally form around any implant in your body. She underwent bilateral breast implant removal, capsulectomies, breast lift (Wise pattern with auto-augmentation), and fat transfer to the breasts (250 cc to the right and 378 cc to the left breast). She feels much better with her implants out.Dr. Sarah M. Elswick
Case 11- Breast Lift and Fat Grafting
This is a patient in her 40s who previously underwent a vertical mastopexy with another surgeon and subsequently experienced a 70 pound weight loss. She was bothered by the volume loss of her breasts as well as the scarring. She underwent a revision of the vertical mastopexy with autoaugmentation from the lateral chest wall (the “side boob”) and fat grafting to the breasts. A total of 300 cc of fat was injected into the right breast and 370 cc of fat was injected into the left breast.Dr. Sarah M. Elswick
Breast Fat Grafting
Case 100- Breast Fat Transfer and Liposuction of the Axillas
This is a patient in her 40s who was undergoing a tummy tuck and wanted to repurpose some of the fat that was going to be removed with that surgery. She had concerns about her breasts, including asymmetry, loss of volume in the upper aspects of the breasts, and extra fat near the armpits (otherwise known as “tank top boobs”). Fat was harvested from her abdomen during the tummy tuck via liposuction and transferred to her breasts, 390 cc into the right breast and 340 cc into the left breast. 125 cc of fat was removed from her axillas as well.Dr. Sarah M. Elswick
Case 141-Breast Implant Removal and Breast Reduction
This is a patient in her 60s who underwent a breast augmentation mastopexy (lift) in her 30s with another surgeon. She had multiple revisions after this. She had Mentor 250 cc silicone implants at her most recent revision. Throughout the years her breasts increased in size with pregnancy and weight gain. She is currently a DD cup and wanted to be a C cup post-op. She underwent a bilateral breast implant removal and breast reduction (superomedial pedicle) with GalaFLEX mesh placement (to support the weight of her breasts given her very thin, stretched out skin). 559 g (1.23 pounds) of tissue was removed from the right breast and 438 g (0.96) from the left breast in addition to the weight and volume from the implants. She is beyond happy with her propionate breasts that fit better in clothing!Dr. Sarah M. Elswick
Breast Reductions
Case 114- Breast Reduction
This is a patient in her 30s with DDD breasts who desired a breast reduction to help with symptoms including back/neck/shoulder pain, shoulder grooving and redness from her bra straps, and difficulty doing her job (she uses her arms a lot). She had tried numerous treatments, including chiropractic therapy, massages, a back roller, and specialty bras but continued to have symptoms. She underwent a bilateral breast reduction using a superomedial pedicle (this technique saves the breast tissue in the cleavage area, helping to maintain a better shape over time). 516 g (1.1 pounds) was removed from the right breast and 442 g (1.0 pounds) from the left breast.
Case 115- Breast Reduction
Breast Reduction This is a patient in her teens with DDD breasts who was interested in a breast reduction. Her symptoms included back, shoulder, and neck pain that limited her ability to work and exercise. She also had shoulder grooving from her bra straps which dug in so tight that they would cause headaches. She also had breakouts between her breasts. She had tried numerous treatments, including pain medications, exercise, and using antibacterial soap. She underwent a bilateral breast reduction A total of 1006 g (2.2 pounds) was removed from the right breast and 700 g (1.5 pounds) from the left breast.
Case 103- Breast Reduction
This is a patient in her 30s with DDD breasts who wanted a breast reduction to treat the multiple symptoms she had from her large breasts after gaining weight. She also wanted her breasts to be perkier. She wanted to look better in clothing and to feel her age. Her symptoms included back and neck pain and shoulder grooving from her bra straps. She had tried numerous treatments, including pain medications and exercise. She underwent a bilateral breast reduction and liposuction of the side of the chest and armpits. A total of 707 g (1.6 pounds) was removed from the right breast and 511 g (1.1 pounds) from the left breast and 600 cc from each side boob (1.3 pounds). She is now a D cup.
Case 76- Breast Reduction
This is a patient in her 30s with H breasts who desired a breast reduction to help with symptoms including back/neck/shoulder pain, rashes under the breasts, shoulder grooving from her bra straps, and difficulty finding clothes that fit appropriately. She had tried numerous treatments, including pain medications, physical therapy, and powders/creams for the rashes but continued to have symptoms. She underwent a bilateral breast reduction; 854 g (1.9 pounds) was removed from the right breast and 726 g (1.6 pounds) from the left breast.Dr. Sarah M. Elswick
Case 20- Breast Reduction
This is a patient in her 20s with DDD breasts who desired a breast reduction to help with symptoms including back/neck/shoulder pain and a pulling sensation in her breasts. Having large breasts was also difficult for her socially; she felt like that was all that people noticed about her. She had tried numerous treatments, including pain medications and anti-fungal and chafing powders but continued to have symptoms. She underwent a bilateral breast reduction; 510 g (1.12 pounds) was removed from the right breast and 580 g (1.27 pounds) from the left breast. She is a B cup now and is ecstatic about the size!
Case 8- Breast Reduction
This is a patient in her 20s with H breasts who desired a breast reduction to help with symptoms including back/neck/shoulder pain and shoulder grooving from her bra straps. She had tried numerous treatments, including pain medications, chiropractic treatments, massage, extra supportive bras, and even wearing two bras at once but continued to have symptoms. She underwent a bilateral breast reduction; 1108 g (2.44 pounds) was removed from the right breast and 1048 g (2.31 pounds) from the left breast. She is a D cup now. You can now see her hourglass figure now that her breasts don’t sit on her abdomen!
Case 27- Breast Reduction
This is a patient in her 50s with DD breasts who desired a breast reduction to help with symptoms including rashes under the breasts, shoulder grooving, and neck, and shoulder pain. She underwent a bilateral breast reduction including liposuction of the armpit and chest wall (adjacent to the breasts); 546 g (1.20 pounds) was removed from the right breast and 614 g (1.35 pounds) from the left breast.Dr. Sarah M. Elswick
Case 30- Breast Reduction
This is a patient in her 20s with 34DDD breasts who wanted a breast reduction to help with symptoms including back/neck/shoulder/breast pain, rashes under the breasts, and shoulder grooving from her bra straps. She wears two bras at once and had tried other treatments to improve her symptoms, which didn’t work. She underwent a bilateral breast reduction; 1511 g (3.3 lbs) was removed from the right breast and 1627 g (3.6 lbs) from the left breast. That is just shy of 7 pounds of breast issue being removed!Dr. Sarah M. Elswick
Case 23- Breast Reduction
This is a patient in her 60s with DD breasts who desired a breast reduction to help with symptoms including breast, neck, and shoulder pain. She also had a history of a left breast biopsy which resulted in asymmetry and nipple inversion. She underwent a bilateral breast reduction; 769 g (1.7 pounds) was removed from the right breast and 391 g (0.9 pounds) from the left breast. She also had liposuction of the armpit and chest wall (adjacent to the breasts) and left nipple reconstruction with extra skin from the breast reduction to help give the nipple more projection.Dr. Sarah M. Elswick
Case 29- Breast Reduction
This is a patient in her 20s with H breasts who desired a breast reduction to help with symptoms including rashes along the breasts, shoulder grooving, and back, neck, and shoulder pain. She underwent a bilateral breast reduction; 1130 g (2.49 pounds) was removed from the right breast and 1248 g (2.75 pounds) from the left breast. Many insurance companies will cover this surgery if you have symptoms from large breasts.Dr. Sarah M. Elswick
Case 25- Breast Reduction
This is a patient in her 20s with FF breasts who desired a breast reduction to help with symptoms including back, neck, and shoulder pain. She underwent a bilateral breast reduction; 527 g (1.2 pounds) was removed from the right breast and 544 g (1.2 pounds) from the left breast. Many insurance companies will cover this surgery if you have symptoms from large breasts.Dr. Sarah M. Elswick
Case 22- Breast Reduction
This is a patient in her 20s with H/I breasts who desired a breast reduction to help with symptoms including back/neck/shoulder pain, rashes under the breasts, difficulty maintaining her posture, and shoulder grooving from her bra straps. She had tried numerous treatments, including pain medications, massage therapy, and even wearing two bras at once (and you thought one was bad)! She underwent a bilateral breast reduction; 1484 g (3.3 lbs) was removed from the right breast and 1500 g (3.3 lbs) fromthe left breast. She now has relief from carrying around all that extra weight!Dr. Sarah M. Elswick
Case 26- Breast Reduction
This is a patient in her 30s with H breasts who desired a breast reduction to help with symptoms including rashes under the breasts, shoulder grooving, and neck, back and shoulder pain. She underwent a bilateral breast reduction including liposuction of the armpit and chest wall (adjacent to the breasts); 338 g (0.75 pounds) was removed from the right breast and 488 g (1.06 pounds) from the left breast.Dr. Sarah M. Elswick
Case 21- Breast Reduction
This is a patient in her 20s with DDD breasts who desired a breast reduction to help with symptoms including back/shoulder/breast pain, rashes under the breasts, shoulder grooving from her bra straps, and difficulty exercising. She had tried numerous treatments, including pain medications, chiropractor treatments, wearing multiple bras, and even wearing a bra 24/7, but still had symptoms from her large breasts. She underwent a bilateral breast reduction; 524 g (1.2 pounds) was removed from the right breast and 370 g (0.8 pounds) from the left breast. Breast reductions can also help to fix asymmetries, like this patient had.Dr. Sarah M. Elswick
Case 28- Breast Reduction
This is a patient in her 20s with E cup size breasts who desired a breast reduction to help with symptoms including rashes along the breasts and back as well as neck, and shoulder pain. She underwent a bilateral breast reduction; 414 g (0.91 pounds) was removed from the right breast and 448 g (0.99 pounds) from the left breast. Many insurance companies will cover this surgery if you have symptoms from large breasts.Dr. Sarah M. Elswick
Breast Reconstruction
Breast Reconstruction - Direct-to-Implant
Case 109- Breast Reconstruction: Direct-to-Implant and Breast Reduction
This is a patient in her 60s who was diagnosed with recurrent right breast cancer. She previously underwent a right lumpectomy and radiation. She was very discouraged about the appearance of her right breast and stated she “did not feel like a woman anymore.” She wanted the left breast to be smaller and perkier as well. She underwent a right skin-sparing mastectomy with direct-to-implant reconstruction and a left breast reduction. She has a Sientra smooth round HSC low profile 400 cc silicone implant placed above the muscle (pre-pectoral) on the right side. A breast reduction (without an implant) was performed on the left side with removal of 1160 g of tissue. Despite the cancer, this was a very restorative surgery and the patient has regained her confidence now.
Case 119- Breast Reconstruction: Direct-to-Implant with Mastopexy
This is a patient in her 60s who was diagnosed with left breast cancer. She also had a history of right breast cancer treated with lumpectomy and radiation over 10 years prior. She was a 34DD and wanted to be the same size or smaller after her breast reconstruction. She underwent bilateral skin-sparing mastectomies with direct-to-implant breast reconstruction with mesh (ADM) and a breast lift (Wise pattern). She has Sientra HSC+ smooth round moderate plus silicone 385 cc implants placed above the muscle on each side. She can pursue nipple areola reconstruction in the future if desired.
Case 87-Breast Reconstruction: Direct to Implant
This is a patient in her 40’s who was diagnosed with right breast cancer. She was a DD cup prior to her reconstruction and wanted slightly smaller breasts after surgery. She underwent bilateral skin sparing mastectomies with direct-to-implant reconstruction. She has Sientra smooth round moderate 700 cc silicone implants with mesh (GalaFLEX on the lower aspect and acellular dermal matrix on top) placed above the muscle (pre-pectoral). The incision used for her mastectomy keeps the scar hidden under the breast (where an underwire from a bra would be located) so it cannot be seen from the front.Dr. Sarah M. Elswick
Case 175-Breast-Reconstruction
Breast Reconstruction: Right Direct-to-Implant with Breast Lift (Mastopexy) and Left Breast Reduction. This is a patient in her 40’s who was diagnosed with right breast cancer. She was a DD cup prior to her reconstruction and was not concerned about her size after reconstruction. She underwent a right skin-sparing mastectomy with direct-to-implant reconstruction. She had a Sientra smooth moderate plus 650 cc silicone implant with GalaFLEX mesh placed above the muscle (pre-pectoral) on the right side. The breast lift was done through Wise pattern (anchor) incisions. A breast reduction was also performed on the left side with removal of 197 g (0.43 lb) of tissue to help achieve symmetry. She underwent chemotherapy and required radiation to the right breast after surgery.
Case 74- Breast Reconstruction : Direct to Implant with Mastopexy
This is a patient in her 30s who was diagnosed with right breast cancer. She was a 38 DDD cup prior to surgery and wished to be a C cup after surgery. She underwent bilateral skin-sparing mastectomies, with a breast lift pattern, and direct-to-implant reconstruction with mesh. She has Mentor round moderate plus xtra 545 cc silicone implants placed above the muscle (pre-pectoral).Dr. Sarah M. Elswick
Case 35- Breast Reconstruction: Direct to Implant
This is a patient in her 40s who was diagnosed with left breast cancer. She underwent a left skin-sparing mastectomy with direct-to-implant reconstruction. She has a Mentor round high profile 550 cc silicone implant placed above the muscle (pre-pectoral). After her surgery, she required radiation to the left breast. Anytime patients have a mastectomy just on one side (especially combined with radiation), they will have some asymmetry with their natural breast. Procedures can be done to help with symmetry, including breast lifts, breast reductions, and even breast augmentations.Dr. Sarah M. Elswick
Breast Reconstruction - Tissue Expander
Breast Reconstruction - Goldilocks
Case150-Breast-Reconstruction: Bilateral Goldilocks Reconstruction
This is a patient in her 60’s who was diagnosed with right breast cancer. She was an H cup prior to her reconstruction and wanted much smaller breasts after surgery. She underwent bilateral skin sparing mastectomies with simultaneous Goldilocks reconstruction. A Goldilocks reconstruction utilizes the patient’s own skin and fat left over after the mastectomy and sometimes even the excess tissue beside the breast or in the back for reconstruction. In this case, the patient wished to limit the contour irregularity from her mastectomy and have a small breast if possible. Additional volume can be added down the road with fat grafting if desired.Dr. Sarah M. Elswick
CASE-183-Breast Reconstruction
Breast Reconstruction: Bilateral Goldilocks Reconstruction. This is a patient in her 60’s who was diagnosed with left breast cancer. She was a DD cup prior to her reconstruction and wanted smaller breasts after surgery. She underwent bilateral nipple-sparing mastectomies with simultaneous Goldilocks reconstruction, using her own skin and fat left over after the mastectomy and the excess tissue beside the breast to recreate a breast. The she had a bilateral breast lift was done through Passot (inframammary fold) pattern incisions with free nipple grafts. She wanted a simple breast reconstruction that would allow her to get back to life quickly. Additional volume can be added down the road with fat grafting if desired.
Breast Reconstruction - OncoPlastic Reduction
Breast Reconstruction - Fat Grafting
Breast Reconstruction - Revision
Case144-Breast Reconstruction Revision: Right Breast Implant Removal and Bilateral Mastopexy (Lift) with Auto-Augmentation and GalaFLEXMesh
This is a patient in her 70’s who underwent a breast reduction years ago with another surgeon. She lost her right nipple and areola and some breast tissue. Shortly thereafter she had a breast augmentation with a 200 ccsilicone implant on the right side with a plastic surgeon. Throughout the years she experienced weight fluctuations. She now wants better symmetry of her breasts and an improvement in the loose, floppy skin. She underwent a right breast implant removal with a bilateral breast lift (Wise pattern with auto-augmentation) with GalaFLEX mesh (a dissolvable mesh which helps to hold the breast shape over time).Dr. Sarah M. Elswick
Case 37- Breast Reconstruction Revision
This is a patient in her 60s who was unhappy with her breast reconstruction performed by another surgeon. She has a history of right breast cancer and initially underwent 2 lumpectomies, but had persistent cancer and required a mastectomy. She chose to undergo bilateral mastectomies with delayed submuscular tissue expander/implant reconstruction with Mentor silicone moderate plus profile implants (700 cc on the right side and 600 cc on the left side) with nipple reconstruction and a right nipple areolar tattoo. She never liked the shape or size of her reconstruction. She had fullness in the armpit area and had dents in the lateral part of the breasts on both sides. She wanted the breasts to be slightly bigger and more symmetric with a smoother appearance. She was also bothered by the movement of the implants when she used her chest muscles (animation deformity) and had discomfort of the breasts. She underwent bilateral breast implant removal and replacement with larger Mentor MemoryGel smooth high profile xtra breast implants (790 cc), bilateral breast reconstruction plane change to prepectoral position with acelluar dermal matrix, bilateral chest wall lipectomy, and fat grafting to bilateral breasts (right 100 cc, left 112 cc).Dr. Sarah M. Elswick
Case 38- Breast Reconstruction Revision
This is a patient in her 50s with a history of left skin-sparing mastectomy for breast cancer. She underwent left breast reconstruction with a submuscular tissue expander followed by a saline implant and nipple areola reconstruction with a tattoo as well as a right breast augmentation for symmetry performed elsewhere over 10 years prior. She did not require any radiation therapy. She recently experienced rupture of her left saline implant. She desired a revision of her reconstruction, including replacement of the ruptured left breast implant, better symmetry, improved contour (specifically addressing the excess skin and fat along the outer breasts), and a reduction in size. On the left side she underwent removal of the ruptured saline implant and replacement with a Mentor round silicone 605 cc smooth moderate plus profile Xtra implant, pocket revision to improve the cleavage area and tethered scar (capsulotomy and capsulorrhaphy), scar revision along the lateral breast to remove the excess soft tissue, and fat grafting (174 cc injected into the cleavage area and indentation along the upper outer breast, harvested from the lateral chest wall and abdomen). On the right side she underwent breast implant removal with capsulectomy (removal of normal scar tissue around the implant) and a breast reduction with a superomedial technique; a total of 710 g (1.6 pounds) of breast tissue was removed with the breast reduction.Dr. Sarah M. Elswick
Breast Implant Removal
Case 141-Breast Implant Removal and Breast Reduction
This is a patient in her 60s who underwent a breast augmentation mastopexy (lift) in her 30s with another surgeon. She had multiple revisions after this. She had Mentor 250 cc silicone implants at her most recent revision. Throughout the years her breasts increased in size with pregnancy and weight gain. She is currently a DD cup and wanted to be a C cup post-op. She underwent a bilateral breast implant removal and breast reduction (superomedial pedicle) with GalaFLEX mesh placement (to support the weight of her breasts given her very thin, stretched out skin). 559 g (1.23 pounds) of tissue was removed from the right breast and 438 g (0.96) from the left breast in addition to the weight and volume from the implants. She is beyond happy with her propionate breasts that fit better in clothing!Dr. Sarah M. Elswick
Case 40- Breast Implant Removal and Mastopexy
This is a patient in her 40s who had a breast augmentation 20 years prior. She developed capsular contracture of her breast implants. She underwent multiple revisions to treat the capsular contracture elsewhere but kept having recurrences. She had 600 cc silicone implants in place above the muscle and was a DDD cup. She underwent removal of the implants, capsulectomies (removing the hardened capsules around the implant), a breast lift with auto-augmentation (rearranging the patient’s own breast tissue to improve the volume of the breasts in the cleavage area), and inverted nipple repair. Her breasts are soft, natural, and no longer painful. She feels like a woman again!Dr. Sarah M. Elswick
Case 31- Breast Implant Removal
Implant Removal Cosmetic – This is a patient in her 70s who developed a grade III capsular contracture and ruptured implants after silicone implant placement over 40 years prior. She underwent a bilateral implant removal (approximately 200 cc) and total capsulectomy. The patient was not interested in having a breast lift.Dr. Sarah M. Elswick
Case 73- Breast Implant Removal, Mastopexy, and Fat Transfer
This is a patient in her 40’s who underwent a breast augmentation in her 20’s with another surgeon. She had recalled McGhan textured teardrop 380 cc saline implants in place under the muscle. Subsequent to this she had children, breastfed, and gained some weight. Prior to her augmentation she was a B cup. Recently she developed pain in her breasts. On exam, she was found to have capsular contracture, which is hardening of the capsules that naturally form around any implant in your body. She underwent bilateral breast implant removal, capsulectomies, breast lift (Wise pattern with auto-augmentation), and fat transfer to the breasts (250 cc to the right and 378 cc to the left breast). She feels much better with her implants out.Dr. Sarah M. Elswick
Breast Revision
Case 40- Breast Implant Removal and Mastopexy
This is a patient in her 40s who had a breast augmentation 20 years prior. She developed capsular contracture of her breast implants. She underwent multiple revisions to treat the capsular contracture elsewhere but kept having recurrences. She had 600 cc silicone implants in place above the muscle and was a DDD cup. She underwent removal of the implants, capsulectomies (removing the hardened capsules around the implant), a breast lift with auto-augmentation (rearranging the patient’s own breast tissue to improve the volume of the breasts in the cleavage area), and inverted nipple repair. Her breasts are soft, natural, and no longer painful. She feels like a woman again!Dr. Sarah M. Elswick
Case 19- Breast Augmentation Revision
This is a patient in her 20s who underwent a breast augmentation approximately 2 years prior. She had bilateral subglandular (above the muscle) breast augmentation with Natrelle smooth round moderate profile implants (330 cc on the right and 310 cc on the left) via inframammary fold incisions by another surgeon. Over time she notes that her implants dropped. She also wanted to be slightly larger. The patient underwent a bilateral breast augmentation revision, with removal of her old implants, plane change (moving the implants from above the muscle to under the muscle), and placement of new, larger implants. She now has Mentor round moderate plus profile 450 cc implants.Dr. Sarah M. Elswick
Case 41- Breast Augmentation Revision
This is a patient in her 30s who underwent a breast augmentation 15 years prior. She has had multiple revisions and a breast lift elsewhere. She noticed that the breasts changed with having children. She sustained a rupture of her left breast implant and desired a revision of her breast augmentation on both sides to bring her implants up and in and decrease the size slightly. She had Allergan Naturelle style 168 (moderate profile) saline implants in place, filled to 650 cc on the right and 700 cc on the left. The patient underwent a bilateral breast augmentation revision, with removal of her old implants, pocket revision (capsulotomies and capsulorrhaphies), Galaflex mesh placement, bilateral mastopexy (Wise pattern on the right and vertical on the left) and placement of new, slightly smaller implants (Allergan SCX 615 on the right and 650 on the left).Dr. Sarah M. Elswick
Case 73- Breast Implant Removal, Mastopexy, and Fat Transfer
This is a patient in her 40’s who underwent a breast augmentation in her 20’s with another surgeon. She had recalled McGhan textured teardrop 380 cc saline implants in place under the muscle. Subsequent to this she had children, breastfed, and gained some weight. Prior to her augmentation she was a B cup. Recently she developed pain in her breasts. On exam, she was found to have capsular contracture, which is hardening of the capsules that naturally form around any implant in your body. She underwent bilateral breast implant removal, capsulectomies, breast lift (Wise pattern with auto-augmentation), and fat transfer to the breasts (250 cc to the right and 378 cc to the left breast). She feels much better with her implants out.Dr. Sarah M. Elswick
Case 39- Breast Fat Grafting
This is a patient in her 30s who previously underwent a breast augmentation with another surgeon and subsequently required a revision. She was bothered by the flat area on the lower aspect of the right breast and the tethering of the scar. She underwent fat grafting to the inferior aspect of the right breast and the right areola with release of the scar. A total of 59 cc of fat was injected into the right breast (the superior areola and the inframammary fold scar).Dr. Sarah M. Elswick
Case 33- Breast Augmentation Revision
This is a patient in her 50s with a history of a sub muscular breast augmentation with saline implants approximately 15 years prior performed by another surgeon. Her old implants were high profile saline implants filled to about 500 cc. She was interested in having smaller implants and perkier breasts. She underwent a bilateral implant exchange to Mentor round silicone 350 cc moderate plus profile implants. Prior to placing the implant, the pocket where the implant was located was revised to help the implant sit in the proper position. This involved opening the pocket in cleavage area and using sutures to close down the outside of the pocket. The revision was completed with a vertical mastopexy (lift) with autoaugmentation.Dr. Sarah M. Elswick
Case 11- Breast Lift and Fat Grafting
This is a patient in her 40s who previously underwent a vertical mastopexy with another surgeon and subsequently experienced a 70 pound weight loss. She was bothered by the volume loss of her breasts as well as the scarring. She underwent a revision of the vertical mastopexy with autoaugmentation from the lateral chest wall (the “side boob”) and fat grafting to the breasts. A total of 300 cc of fat was injected into the right breast and 370 cc of fat was injected into the left breast.Dr. Sarah M. Elswick
Gynecomastia
Case-96-Gynecomastia
This is a patient in his 40’s with bilateral gynecomastia. He desired a flatter, more masculine contour of the chest. He underwent liposuction of the fatty tissue and excision of the breast tissue with an arthroscopic shaver. 400 cc of tissue was removed from the left chest wall and 400 cc from the right chest wall. This is a minimally invasive technique that few surgeons in Michigan perform and can be done through a few ¼” incisions that are nicely camouflaged.
Case 48- Gynecomastia
This is a patient in his 30s with bilateral gynecomastia. He desired a flatter, more masculine contour of the chest. He underwent liposuction of the fatty tissue and excision of the breast tissue with an arthroscopic shaver. 200 cc of tissue was removed from the left breast and 300 cc from the right breast. This is a minimally invasive technique that few surgeons in Michigan perform and can be done through a few ¼” incisions that are nicely camouflaged.Dr. Sarah M. Elswick
Case 47- Gynecomastia
This is a patient in his 30s with bilateral gynecomastia, including a painful left breast mass. He desired an improvement in his symptoms and a more masculine contour of the chest. He underwent excision of the left breast mass through a periareolar incision followed by liposuction of the fatty tissue and excision of the breast tissue with an arthroscopic shaver of both breasts. 200 cc of tissue was removed from the left breast and 100 cc from the right breast.Dr. Sarah M. Elswick
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