1. The breast implants look disproportionate and make the patient look unbalanced.

2. Large implants in small women make them look fat in their clothes and top-heavy.

3. Large saline breast implants create more fitting of the skin and more wrinkling and rippling.

4. Large saline breast implants cause more dissent of the implant overtime and therefore more sagging.

5. Large saline breast implants because of the thinning of the skin feel like a waterbed.

It is true that some of these changes could happen with large silicone breast implants of equivalent size, however, they are more pronounced with saline breast implants.

To solve this issue and create a more balanced look for each of these women, I removed the larger implants replaced them with an appropriate sized silicone breast implant and then designed the breast lift over this new implant. As I’ve written before, you can make preliminary markings before the surgery but the actual proof is in the operating room. With the new breast implants in place, temporary sutures are placed on the outside of the skin without any incisions and the breast is tailor tacked to the appropriate shape. This process may take several tries until we are able to achieve the ideal shape. At that point, the extra skin is removed and the breast is tightened and lifted.

Breast revisions are never an easy operation but they are very satisfying one for both the patient and the doctor. The difference in comfort, aesthetics, and self-image are amazing. Every single patient that I have converted from saline to silicone implants has commented on how much better they feel. The average breast implant should last 20 to 30 years but if you have a result that you are not happy with, there is no reason to wait that long to change it.

Of course, the best option would have been to choose the right size breast implant from the very beginning. This is why I discuss the downside of choosing breast implants that are too large in the first place and then I don’t have to worry about the patient coming back in because they are unhappy with their results!

Sheyla Hershey's largest Breast implants in the world

According to her official Website, Sheyla Hershey’s breast implants made her a size M (whatever that is), and she was awarded the Brazilian equivalent of the Guinness Book of World’s Records for largest breast implants after her most recent breast augmentation.

In the United States, plastic surgeons are only allowed to place implants up to 800 cc and for her to achieve this size, I’m guessing she was fitted with 4 implants of perhaps 800 cc each? Sheyla Hershey was originally from Brazil and flew back home where the laws are less strict so she could have this breast augmentation done. Since she is only 5’2 she would appear quite lopsided, as the attached picture illustrates.

I’ve blogged before where I discussed Heidi Montag’s breast implants,  about all the reasons why you don’t want to select breast implants that are too big for your body. In the case of Sheyla Hershey, it is even more an indication of likely mental illness than a misdirected attempt at having an attractive figure. Breasts this size are dangerous, painful and will have to eventually be removed 100% of the time, leaving the patient permanently disfigured.

NineMSN reported on the story:

“We’ve already taken her to surgery twice,” said the surgeon in charge of the breast removal, Dr Ron Bucek.

“We needed to open the area up to allow it to drain because we can’t leave an infection in a contained zone.”

According to reporting by the Herald Sun in Australia, many attempts were made to save her from having to remove four implants, TWO in each breast!

“But after the operation, Hershey became seriously ill and has since been closely monitored by a cosmetic surgeon, Dr. Ron Bucek, and an infectious disease expert, Dr. Shazia Gill.

Before yesterday’s surgery to remove the implants, Bucek performed two other operations to help drain the infected areas, and a special vacuum had been suctioning the infection from Hershey’s body 24 hours a day for months.

“It’s the only thing that has saved my life, to be honest,” Hershey said of the device, though she added that it was “annoying” and “heavy.”

My Fox Houston gave the most detailed report:

“None of the bacteria have cultured out. We had to start her on a third antibiotic, because it wasn’t resolving as rapidly as we wanted to see, so she’s on three antibiotics, and she was on an anti-fungal medication during this time as well,” says Dr. Gill.

Because of the severity of the infections, doctors have been closely monitoring Hershey twice a week.

“I look at white blood cell count, I look at electrolytes and inflammation and right now her drug level. She’s on one antibiotic if her levels get too high she can damage her hearing as well as kidneys, she is on very strong antibiotics,” explains Dr. Gill.

Even with all of this medical intervention, Hershey’s body hasn’t been able to ward off the infection. It has been progressively getting worse.

“What’s happening, the skin is opening because the implants, the two on each side, are beginning to open that area up”, says Dr. Bucek. Hershey’s doctors are confident that she will restore her health by removing all four implants.

Dr. Gill showed Sheyla’s CT scan to FOX 26 to demonstrate how the two implants are stacked up on each side. She says there is a lot of inflammation and thickening of the skin.”

It amazes me that there are doctors ANYWHERE in the world who would butcher an obviously disturbed young woman. Now she’s had to undergo what is essentially a double mastectomy at age 28 because along with the removal of all 4 implants, she also lost most of her breast tissue and her skin is going to be in terrible shape. I can’t imagine any number of surgeries that will allow her to have normal, attractive looking breasts now.

On the TresSugar blog, “Gigglesugar” asked in her poll:

Some of the happiest patients I have ever had here at Advanced Concepts in Plastic Surgery have been breast reduction patients.  For breast reduction patients it’s as much about feeling better as looking better.  Large breasts can cause severe back neck and shoulder pain as well as deep grooves in the shoulders.  Some of these patients and had large uncomfortable breasts for 10, 20, 30 or 40 years.  That’s a long time to be miserable.

For a standard breast reduction the new nipple position is determined and is marked at a much higher level than it currently is, usually at the level or just above the breast fold.  Additional markings to unfold the breasts are drawn.  In most cases the nipple stays attached to the chest.  The breast is unfolded and the extra tissues are removed.  The breast is then sutured back together in a smaller and higher position.  The new smaller perkier breast is much more comfortable and for the vast majority of patients the back, neck and shoulder pain goes away.

Because most people have breast reduction for functional reasons it is often covered by insurance.  Years ago the insurance companies were much more liberal about who was covered.  But the insurance companies have gotten much cleverer about hanging onto their money.  They have set height and weight restrictions so that many people who are only modestly overweight have to lose considerable amounts of weight to even qualify.  They also have increased the amount that has to be removed up to 500g, about 1 pound.  For many women, who have legitimate complaints of a pound per side, is a lot to remove leading them with minimal breast tissue left.

Other forms of breast reduction included liposuction, periareolar, (only one scar around nipple), or vertical using the lollipop scar.  Individual patients may be better candidates for one or the other of these breast reductions.  Some doctors preferred to do only one type of reduction whereas I am comfortable with several.  If the patient’s breasts are very large and very saggy only the standard anchor scar procedures can take up enough of the excess to get a good result.  For smaller reductions many techniques work very well.

Scars have been a problem in the past.  With the introduction of a new quill barbed sutures which grab a hold tissues better longer scars have become finer and much less likely to stretch out.

Breast reduction surgery changes people’s lives.  Besides making them feel good and look better it can alleviate chronic pain.  I’ve seen two patients who have avoided major back surgery because of this.  I’ve had two other patients who had an incidental breast cancer removed at the very earliest stage, something that never would have happened without surgery.