Age: 36 Breast Augmentation
This patient who is 5’6″ and 153 pounds, desired a breast enhancement. She has two children. She is seen here after a bilateral breast augmentation with 325cc silicone implants placed through an incision beneath the breast. She says she is much more confident and that her husband absolutely loves the results!
Age: 38 Breast Augmentation
This is a 38 year old female who is 5’6’ and 130 pounds who was interested in a breast enhancement. Her main goal for the enhancement is to fit bras and clothing better. On the preoperative photos you can clearly see that she is very asymmetrical (both her breasts and her underlying ribs). The left breast is larger and sits on ribs that project more than the right side. You can clearly see this difference in the photo on the bottom left that was taken in the operating room at the foot of the table, looking up at her breasts.
When we tried on the implant sizers it appeared that a 75cc volume difference appeared to make her breasts look most symmetrical. She is seen here about three years after a bilateral breast augmentation with smooth silicone implants placed beneath the muscle through an inframammary incision using 400cc on the right and 325cc on the left.
What is most remarkable is how symmetrical her breasts appear with the augmentation alone. I always tell patients that no two breasts will ever look the same and this is even less likely when a woman starts off with such different breasts. However, this woman’s case they look remarkably similar. This outcome is more likely if your surgeon is experienced and has a good eye at making the appropriate adjustments. This is done in my office by trying on implant sizers with different shirts until we are all in agreement that the breasts look their best in not only volume, but also shape and size symmetry. With these relatively large implants, I worry about stretching of the skin over time. The bra that she is wearing exaggerates her cleavage which means that it is supporting the weight of her implants and giving the skin a break.
It is possible to create improved symmetry when breasts are asymmetrical by manipulating the size and type of implants as well as performing ancillary procedures like liposuction or breast tissue removal.
Age: 38 Breast Augmentation
This mother of one, who is 5’5″ and 145 pounds complained of having deflated breasts. She is seen here after a bilateral augmentation with 350cc silicone implants placed beneath the muscle through an inframammary incision. She is seen here at five months after her procedure and you can certainly appreciate the difference. Her breasts have come alive and are no longer deflated. She has filled out her breast tissue and enjoys a modest lift. Her collapsed nipple/areola complex is no longer sad. We both agreed that a breast lift was not needed.
This patient says that she loves to shop for clothes and bras. People look at her cleavage like they never had before. Her husband loves her breasts and what it has done for her self esteem. She was looking forward to me sending the pre and postoperative photographs side by side because she couldn’t remember what she used to look like!
Age: 32 Breast Augmentation
This patient, 5’4″ and 110 pounds was considering a breast enhancement. She is seen here after a bilateral enhancement with 275cc silicone implants placed through an incision beneath the breast under the muscle. She is pleased with her results as it has improved her self esteem tremendously and she feels more like a woman. In fact, she said, “My front is not like my back now.”
Her case illustrates several important points. First, she is very thin with little body fat. Second, her breasts sit up high on her chest wall close to her clavicles. Since she has little tissue cover on top of her implant, the shape of her breast will be the shape of her implant. Since her implants are round, she has a round appearance. The size she chose was small to moderate which is important because if a larger implant is chosen it would appear that her breasts are under her chin. Small people are best off with smaller implants. Larger people can handle larger implants because it’s all about proportion and sustainability. Implants that are too large will not fit on her chest and will appear unnatural and will likely bottom out and look strange. I prefer silicone implants when there is very thin tissue coverage on top of an implant because patients are less likely to experience rippling of the implant.
Age: 24 Breast Augmentation
This is a 5’2″ 120 pound woman who desired a breast enhancement. She has relatively small breasts that are also asymmetrical in size. Her chest wall is also asymmetrical. I elected to perform a bilateral breast augmentation with saline implants placed beneath the muscle through an incision below the breast, 325cc on the left and 300cc on the right. She did not want larger implants that would make her look “heavier”.
Note the overall enhancement, but in particular, see how I was able to create improved symmetry with different sized implants. It is my experience that the vast majority of patients with chest wall and breast asymmetries can be corrected with breast implants.
Age: 23 Breast Augmentation
This patient 6′ tall and 180 pounds. She was an athlete and didn’t like the size or shape of her breasts. She believes that her shoulders are too large. Her breasts are small for her frame and narrow (almost tubular). She has chest wall and breast asymmetries. When we tried on the implant sizers she immediately gravitated to the larger size. She likes that the larger implants make her shoulders look smaller and that her figure is more in balance–she doen’t look like a large young lady.
She was augmented with 650cc silicone implants placed below the muscle through an incision beneath the breast. Note that when I made the incision to place the implant that I had to “fudge” the location because the new crease is actually a lot lower. If I had made it in the existing crease it would have ended up on the face of the breast. She is seen here five months after her procedure. Certainly she is MUCH larger and fuller. She loves her breasts now and I can tell you that she is a changed woman. However, she did develop STRETCH MARKS from her procedure. These are the red lines you can see on the outside of each breast. This is very uncommon; I have seen about three cases in the past twenty years. We do not know why this occurs or who is most likely to develop stretch marks. I can tell you that it seems to occur in younger patients and is probably related to the volume of the implants (larger implants stretch more). The good news is that she is not concerned with them and she knows that as the reddness goes away that it will be less noticable.
The larger sized implants will require a very supportive bra. Also understand that when you use an implant that has a diameter that is a lot larger than the breast it’s possible to have a “double bubble” type appearance. This is because the smaller breast (hill) sits on top of the larger implant (mountain). It’s important to shape the breast afterwards to flatten the natural breast so that there isn’t a step-off that looks unnatural.
The bottom line is that the larger sized implants have helped her psychologically. Most women prefer not to be considered “large” even if this means that you are not overweight or obese, but just large boned. Combine this with small breasts and there is a dysproportion that makes matters even worse. Creating balance and symmetry with the help of breast implants is one of the most benefical aspects of the breast enhancement process.
