Breast Augmentation Gallery

A 20 year old  Asian woman who wanted fuller breasts.  She has had a benign tumor called a fibroadenoma excised from her right breast at the age of 11 and has some breast asymmetry as well.  She wanted to have a natural appearance and liked the idea of the Ideal Structured saline implants so that she did not have to worry about silent rupture.  She is shown  before and again, 6 weeks after bilateral partial sub-pectoral breast augmentation with Ideal Implants 270-305 filled to 305

Discussion:  Her nipple to fold distance on stretch on her right breast ( the smaller of her two breasts) is 7 cm which would suggest an implant that is 11 cm at the base or less.  The Ideal implant 270-305 when  filled to 305 has a base width of 10.6 cm to which we add 0.3 cm = 10.9 cm corrected  because it is curved to fit on the chest wall.  The measured base width  of her breasts are 11.4 cm on her right breast and 11.9 cm on the left.  So an implant that is 11 cm or less will fit the nipple to fold distance without having too much superior pole convexity or bulging and she won’t have an overly round “implant” look as long as the base width of the implant is less than the base width of her breasts.  We decided to use the same size on each side, using the largest implant that we could use on her smaller breast-if we put a larger implant on that side to balance the slight difference in breast volume then the smaller breast because it has a tighter skin envelope would appear unnatural.  Her breasts look good at 6 weeks and will continue to soften in appearance over the next 4-5 months as the breasts stretch to accommodate the implants.

A woman in her later 30’s who is bothered by a deflated and drooping appearance of her breasts after pregnancy.  She is 5’  1 ½” and 120 lbs and is shown before and again, 2 months after partial subpectoral placement of 350 cc Sientra round smooth high strength gel high profile silicone implants combined with an inverted “T” mastopexy ( breast lift). Tattoos have been blurred for her privacy.

A mother of 1 in her early 40’s who is bothered by a deflated appearance in her breasts after pregnancy and breast pumping.  She is 5”10{ and 146 lbs and is shown before and again, 7 weeks after bilateral partial subpectoral breast augmentation with Sientra round smooth 385 high profile cohesive gel implants.

Discussion: She wished to have a fuller but still natural appearance.  She liked 375 in the office but 400 started to look slightly full.  The implant has a base width of 12, 3 cm and a height of 4.9 cm.  Her breast has a base width of 12.7 cm and an inframammary fold to nipple distance on stretch of 8.5 cm.  When the implant base is less than the breast base then we don’t tend to get an “implant “ look, which she did not want.  The high profile helps to give some fill back to the upper breast.

It is typical to look for an implant base of 11 with a nipple to fold on stretch of 7, 12 with 8 and 13 with 9.  With her nipple to fold on stretch of 8.5 the 12.3 base of her implant fits comfortably.

A woman in her early 30’s who describes herself as a 34 B and wished to be a C cup.
She is 5’5’ and 138 lbs and is shown 7 weeks after partial subpectoral placement of Sientra high strength silicone gel round smooth implants 330 high profile placed through an infra-mammary incision.

An 11 month followup on a medical professional in her early 30’s who would like to have breasts that are fuller but still natural in appearance. She is 5’4” and 110 lbs and is shown before and again, 11 months after partial subpectoral placement of 255 ml Sientra high strength silicone gel round smooth implants placed through in inframammary incision in a partial subpectoral space.

Discussion. Her nipple to IMF on stretch is 7 on her left and 7.5 on her right. Her breast width is 10.8 cm The Sientra 600 series round smooth High Profile 255 is 10.8 cm at the base and fits the size of her breast without being larger than the base and therefore avoids an “implant” look.

A mother of 2 in her early 40’s who is bothered by a deflated appearance of her breasts after pregnancy. She describes herself as a 34 B. She is 5 ft tall and 123 lbs . She was sized in the office and liked the 280 cc High profile round smooth Sientra high strength silicone gel implant. She is shown before and again, 6 weeks after placement of the implants through and inframammary incision in a subglandular space.

Discussion: her case is more challenging because of borderline ptosis with her nipples being located just at the level of the breast fold. A subpectoral placement without a lift would have led to a “waterfall” effect with the breasts dropping off of the implant mound. With a subglandular placement the implants drop with the breast. The size of the implant was selected to match the base width of her breasts.

Update: Our patient is now seen 11 months after surgery.  The sub-glandular placement has allowed the implants to settle with the mildly ptotic ( drooping) breast and gives her a natural appearance.

A mother of 2 in her later 30’s who is bother by a deflated appearance of her breasts after pregnancy. She was a full B cup before pregnancy, became a D cup with pregnancy and now describes herself as a 34-36 A cup . She would like to be fuller but no excessively large and wants to still be natural in appearance. She is shown before and again, 6 weeks after bilateral partial subpectoral breast augmentation with Sientra smooth round high profile high strength cohesive gel 350 cc implants..

Discussion: She has IMF to N on stretch distance of 9 cm and base width of 12.5 cm. This implant is 12 cm at the base. She could have used a implant with a 12.5 cm base width without looking overly round “like an implant” but felt that these larger implants were much too large for her in clothing and she preferred to look like her padded bra but without the padding. She is very pleased with the natural appearance of her breasts after surgery.

A mother of 3 in her later 30’s who is bothered by a deflated appearance of her breasts after breast feeding. She describes herself as a 34 ato b cup and would like to be a c cup. She is 5’3” and 115 lbs and is shown before and again, 6 weeks after bilateral partial sub-pectoral placement of Sientra 385 cc textured round high profile silicone gel implants placed through an inframammary incision

Discussion:
She has chest wall asymmetry and breasts which are higher risk for shifting of the implants, which is more common with a smooth implant. The Sientra microtexture decreases the risk of this shifting with the trade- off of a slightly increased risk of BIA-AlCl. Her breast base width is 11.8 cm and the nipple to inframammary fold on stretch is 9.5 cm. She was sized in the office and liked 350 and 375 but felt that 400 was a little out of proportion. The chosen implant has a base of 12.3 cm and a height of 4.9 cm. This is slightly wider than her existing base and will therefore give her a mild “implant” look for a few months but should then settle in and appear even more natural as the breast stretches slightly.

A mother of 2 in her later 20’s is bothered by a deflated appearance of her breasts after pregnancy, and also would like to be fuller. She describes herself as an A cup and would like to be a full C cup. She is shown before and again, 6 weeks after partial subpectoral breast augmentation with Sientra 440 cc smooth round cohesive high strength silicone gel implants placed through an inframammary incision.

Discussion: She is 5’4” and 150 lbs. She does not mind a mild implant appearance but wishes to be relatively natural in appearance. She has pseudoptosis, and could be at risk for a mild waterfall effect from a subpectoral placement but prefers this and a lower risk of capsular contracture to a subglandular placement where the implant drops with the breast

Her base width is 12.7 cm and the Inframammary fold to nipple distance on stretch is 8.5 cm. She has elected for a Sientra 10621-440 High profile smooth round implant which is 12.8 cm at the base and has 5.1 m in projection. This is just slightly larger in diameter than her base width and early on can give a mild implant appearance but will settle and look even more natural in a few months. A base of 12.5 cm would be perfect of and 8.5 cm nipple to IMF on stretch. Her IMF was reinforced with long lasting but dissolvable sutures at the time of surgery to prevent “bottoming out” and a potential double bubble formation- this give mild superior pole fullness early on but should settle with time as the breast stretches to accommodate the implant.

A mother of 2 in her early 30’s who is bothred by a deflated appearance of her breasts following pregnancy. She is 5’ 3 ½” and 132 lbs and is shown before and again, just one 6 days after bilateral partial subpectoral breast augmentation through an inframammary incision with 385 cc Sientra High profile round smooth cohesive silicone gel implants.

Discussion: The implant is 12.3 cm at the base. Her left breast base is 12.3 cm and her right breast is 12.5 cm. Her inframammary fold to nipple distance on stretch is 9 cm. The 12.3 cm base fills her breast but does not overly stretch her breast and even at just 6 days after surgery has a natural look because it is the proper size for her and is not significantly wider than her excisting breast. With an nipple to breast fold of 9 cm, an implant of 12 cm is needed to adequately fill the breasts. So this implant restores her lost fullness from pregnancy, but because is is not wider than her breast does not give her an “implant look” She is a medical professional and wanted to have a natural appearance after her surgery.