Breast Augmentation Gallery

A woman in her later 30s with a deflated appearance of her breasts after weight loss.  She is 5’ 4 14” and 112 lbs and is shown before and again, 6 weeks after the bilateral partial subpectoral placement of Sientra round smooth moderate profile cohesive silicone gel 355 breast implants. They were placed through an inframammary incision.

An Asian mother of 2 in her later 40’s who described herself as a 32 A cup and wanted to have a fuller but still natural look.  She has some asymmetry with her right breast being higher and slightly more lateral on her chest wall  She does not want an “implant” look.  She is shown before and again, 4 ½ months after bilateral partial sub-pectoral placement of round smooth highly cohesive silicone gel Sientra 255 High profile implants through an inframammary incision.

Discussion: The Sientra 255 HP implant is 10.8 cm at the base.  The measured base width of her breasts was each 10.6 cm and the IMF to nipple distance on the stretch was 7.5 cm.  A larger implant would have been significantly wider than her breast and would have been more likely to give her an overly round “implant” look, which she wanted to avoid.  She is thrilled with her fuller but still natural appearance.

A mother of 3 in her early 60’s who is bothered by a deflated appearance of her breasts after children.  She is 5’ 4” and 116 lbs and is shown before and again, 6 weeks after subglandular placement of Sientra 415  cc high profile  smooth round high strength cohesive silicone gel implants.

Discussion: Although I would more typically recommend a subpectoral placement of the implants ( below the muscle) which may have a lower risk of capsular contracture,  She has some early ptosis or drooping of the breasts.  A subpectoral placement in her case would place her at a higher risk of a “waterfall deformity” with the breasts falling off of the implant mound.  With a subglandular placement, the implants settle with the breasts and gives a more natural appearance.

An Asian mother of 2 in her later 40’s who is bothered by a deflated appearance of her breasts after pregnancy.  She wanted to be fuller but still natural in appearance.  She is shown before and again, 6 weeks after bilateral partial subpectoral placement of Sientra round smooth cohesive silicone gel implants.

Discussion: She has truncal asymmetry and her right breast is positioned higher on her chest, before and after surgery.  This is a “foundation” problem and is not changed with implants.   She is 5’ 3 ½” and 109 pounds and selected Sientra 255 High Profile implants.  This helps to fill the deflation of the upper breast but because it is not wider than the base of her existing breast it does not give an “implant” look.

A mother of 3 in her later 40’s who is bothered by being “ tint in the breast area” and described herself as a 32A cup.  Her breasts became smaller after pregnancy and she now wanted to improve this.  She still wanted to have a natural appearance after surgery.  She is shown before and again, 1 yeaar after partial subpectoral placement of Sientra, High Strength cohesive silicone gel round smooth implants placed through an inframammary incision.

Discussion: She is 5’6” and 148 lbs  Her nipple to infra-mammary  fold distance on stretch is 7.2 cm on the right but just 7 cm on the left.  She elected for a sientra HP 280 cc implant which is 11.1cm at the base.  Typically an 11 cm base fits well with the nipple centered when the distance on stretch is 7 cm.  I reinforced her existing inframammary fold at the time of surgery by anchoring it to the rib periosteum with long lasting dissolvable sutures to prevent it from “giving way” and leading to “bottoming out”.  The Sientra silicone gel implants have the lowest reported rupture rate at 10 years of any of the silicone gel implants on the market. She is thrilled with her fuller but still natural appearance.

A long term follow-up on a lovely mother of 2 in her later 40’s who had breast augmentation with us 16 years ago, using textured silicone gel implants placed in a sub-glandular position.

She has maintained a good result.  The FDA now recommends an ultrasound 6 years after surgery and every 1-2 years thereafter to check for rupture.  Her ultrasound is normal and she does not require any replacement of her implants at this time.

A woman in her early 40’s who had breast augmentation with us 9 years ago, combined with correction of an inverted (retracted)  nipple.  She has smooth, round silicone gel implants placed partial sub-pectoral( below the muscle)  through an inframammary incision,,  and is still thrilled with the natural, beautiful look of her breasts after surgery.  She has maintained her correction of the inverted nipple which was treated with a micro-incision technique to release the tethered nipple ducts.

A mother of 2 in her mid 30’s who would like to have fuller breasts but still natural in appearance.  She is currently a 32 A to B cup and wanted to be a small C. She liked the idea of the Ideal Structured Saline Implant because she would not need to worry about a silent rupture.  She is shown before and again, 6 weeks after bilateral partial sub-pectoral placement of Ideal structured-Saline 270 implants filled to 275 cc, placed through an inframammary incision.

Discussion:  She is thin at 5’ 5 ½” and 127 lbs.  Based on her distance around her chest at the inframammary fold of 29” she is a 32 band bra ( actual measurement plus 3 inches).  Her breast base width is 11.7 cm and her inframammary fold to nipple distance on stretch is 7.4 cm on her right and 7.3 on her left.  Based on her breast dimensions she could have used an Ideal structures saline implant as large as 300-340 ( this implant has a base width of 10.8 when fully filled and when this dimension is adjusted by adding 3 mm to account for the curved base would be the equivalent of 11.1 cm, which would be less than her existing  base width and therefore would not give an overly round or implant look.  Also, it would fit the nipple to IMF fold on stretch distance of 11.3 cm and would not have given excess fullness of the upper breast ( “superior pole convexity”)  When

She was sized in the office with the Mentor sizing system she felt that 300 was simply too big for the look that she wanted. She liked 250 and felt that 275 was “slightly full, but she could live with it”.

More often than not, a patient will get used to a chosen size and then wish that they had gone with a larger size.  But after careful discussion and consideration she felt that she would be most happy with this size.  And I could assure her that it would still have a natural appearance because of the base dimensions of her existing breast.

She is very pleased with her conservative increase in size.

Update: Our patient is now seen 4 months after surgery.  The breasts have “softened” in appearance in look even more natural.

A mother of 2 in her later 30’s who is bothered by a a deflated appearance of her breasts after pregnancy.  She wears a 36 B and was a 38 C when  breast feeding, She liked this size.  She is 5’ 6” and 152 lbs and is shown before and again, 6 weeks after bilateral partial sub-pectoral

( below the muscle) placement of Ideal Structured Saline Implants 405-455 filled to 425

Discussion: she wanted a full but still natural appearing  result.  Her breast base width is 13.27 on her right and 13.21 on her left.  Her nipple to fold on stretch is 9 cm.  So a 13 cm base implant would not give her excessive superior pole convexity ( bulging of the upper breast) and as long as the base width of the implant is less than the width of her breast it should not look overly like an implant.  The base width of the Ideal implant is 12-11.9 from minimum to maximum recommended fill and we add 3 mm to that to get the comparable implant width because of the curved base of the Ideal implant.  I like to undersize the Ideal implants slightly to give a more natural appearance.  I find that I can go a little larger with the silicone gel for patients that want the maximum volume but still a natural appearance.  So the Ideal implant has an empty implant volume of 60 cc, the back chamber is filled to 235 cc and together with the front chamber fill of 130 cc we get the final volume of 425 cc.

Her photos are at just 6 weeks.  I find that it takes 4-5 months for the Ideal implants to settle completely to the final result.  The breasts are “sisters and not twins” and her right breast is slightly larger before and after surgery-because the left breast is slightly smaller we see a little more fullness of the upper breast on her left at 6 weeks- this will typically settle over the next vew months as the breasts stretch slighty to accommodate the implants.