A challenging case in a woman with small breasts and a tight skin envelope, as well as pectus excavatum ( a hollow depression in the chest bone) who wishes to have a natural appearance. When the chest wall is sloped, the implant will tend to migrate “down the slope” towards the middle with time. Therefore we selected textured, cohesive silicone round gel implants. When the tissues are tight the implant needs to be even more precisely matched to the patient. She is 5’5” and 120 lbs and is shown before and again, 22 months after partial subpectoral placement through an inframammary incision. 305 cc Sientra implants were used. Tattoos are blurred for privacy.
A woman in her early 30’s who describes herself as an A-B cup and would like to be closer to the padded C cup bra that she currently wears, but still natural in appearance. She is 5’ 2 1/2” and 112 lbs and after careful sizing in the office based on her tissue measurements and characteristics a 325 cc moderate profile plus smooth round silicone gel implant was selected. She is shown before and again, 6 weeks after partial subpectoral ( below the muscle) placement of the implants through an infra mammary ( at the breast fold) incision. She is thrilled with her fuller but still natural appearance.
A mother of 1 who has gained and lost 90 lbs with her pregnancy. She does not feel feminine because of her flat chest “ like a 14 year old boy” and wants to have a fuller but natural look. She describes herself as a 32 iA but was a 36 C cup before pregnancy. She is 5’6” and 135 lbs. She is shown before and again, 18 months after Sientra, round, 385 cc High Profile silicone gel textured implants. They were placed in a dual plane position through an inframammary ( at the breast fold) incision. The High profile implant was selected to help add some fullness to the upper part of the deflated breast. The goal is to fill but not overly stretch the breast, and her breast was deflated after pregnancy and weight loss. Texture is chosen to decrease the tendency of a smooth implant to drop and/or slip to the side with time. A ”dual plane” allows the implant to be under the muscle in the upper breast and under the breast in the lower breast. This helps when the breast is starting to droop to allow the implant to settle more with the breast and decrease the tendency to a “waterfall” effect where the breast drops off the implant. At 18 months she has maintained a stable and natural looking result.