A woman in her early to mid-30s who describes herself as a B cup and wishes to be a full C cup. She is 5’5” and 134 lbs and is shown before and again, 18 months after bilateral partial sub pectoral ( below the muscle) placement of Sientra high strength gel, smooth round high profile silicone gel implants 330 size. They were placed through an incision at the inframammary fold.
Discussion: The base width of her right breast is 12.3 cm and her left breast is 12 cm. The nipple to inframammary fold distance on the stretch is 9 cm on the right and 8.5 cm on the left.
The 330 HP implant is 11.7 cm at the base. When two breasts are different in size, which is common, we usually limit our size based on the smaller of the two breasts if we wish to maintain a natural appearance. When the implant is bigger than the base width it can start to give an “implant “ look. Also, the nipple-to-breast fold distance on stretch guides us in choosing an implant that is centered under the nipple. Typically, 7 cm on the stretch will accommodate an 11 cm base implant, 8 cm, a 12 cm base, and 9 cm a 13 cm base implant without looking overly “bulgy” (superior pole convexity) in the upper half of the breast. In this case, the implant gives her the volume that she liked during sizing in the office, but still gives her a natural appearance.
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