Breast Augmentation Gallery

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.

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.