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 woman in her later 20’s who wears a 36F cup bra and has problems with back and neck pain as well as difficulty exercising because of the size of her breasts. She is 5’8” and 230 lbs and is shown before and 8 months after a bilateral breast reduction with the removal of around 800 grams of breast tissue from each breast ( 454grams = 1 lb) Her nipples were outworly displaced or “walleyed” and were brought back to the median of her breast. Scars will continue to fade and improve for the next 2 years but her symptoms have resolved and she is thrilled with her new shape and size.
A woman in her early 20’s with bilateral macromastia. She is a 36 DD and has had problems with back pain, difficulty exercising, shoulder pain, grooving and irritation of her shoulders from the bra straps, a rash under the breast in the warmer months and difficulties with her posture. She had lost weight recently but her breasts were still too large. It was especially difficult for her to run. She is 5’ 3 ½” and 134 lbs and is shown before and again, 8 months after breast reduction with the removal of 440 gas from her left breast and 374 grams from her right breast ( there are 454 grams in a pound) to reduce her to a C cup. Her symptoms have all resolved, Scars typically continue to fade and improve over the first 2-3 years.
A man in his later 20’s with gynecomastia following prohormones that he took at the age of 19 for body building. He is bothered in fitted shirts and with his shirt off. His left chest is larger.
He is shown before and again, 4 months after correction with power assisted liposuction using the S.A.F.E. technique ( separation/aspiration/fat equalization) combined with a direct excision of breast tissue through a periareolar incision. He is thrilled with his normal appearance after surgery and can now wear fitted shirts and take his shirt off at the beach.
A 6 week followup on a woman in her early 40’s with bilateral macromastia and breast ptosis
She describes herself as a 40DDD and has had prolems with grooving and irritation of her shoulders from her bra straps, back pain, shoulder pain, difficulty exercising due to the size of her breasts even with wearing extra bras.
She is 5’5” and 182 lbs and is shown just 6 weeks after bilateral breast reduction with the removal of 766 grans from her right breast and 743 grams from her left breast to reduce her to a full C cup. Her symptoms have all resolved. Scars typically will begin to fade and soften after the first 6 weeks and continue to improve for the next 2-3 years.
A nurse and mother of 2 in her early 40’s who had a gastric bypass and lost 126 lbs. She is shown 13 months after mastopexy/brachioplasty and 5 months after Fleur de Lis abdominoplasty with the creation of a new umbilicus. She is thrilled with her new contour. Scars will typically continue to fade and improve for 3 years.
A woman in her late 30’s with a complete split of her right earlobe for more than 12 years. She would like to be able to wear earrings again. She is shown before and again, 3 months after repair in the office and again, just after re-piercing. Scars typically get redder and thicker for 6 weeks and then soften and fade over the next 2 years
A student in her early 20’s who describes herself as a 34 H cup bra and has had problems with back and should pain, difficulty exercising due to the size of her breasts, despite wearing extra sports bras to run. She has grooving and irritation of her shoulders from her bra straps, as well as a rash under the breasts in the warmer weather and problems with her posture. She is 5’9” and 181 lbs and is shown before and again, 4 months after bilateral breast reduction with the removal of more than 500 grams of tissue from her right breast and more than 600 grams of tissue from her left breast to reduce her to a mid C cup. Her areola’s were reduced in size and brought back to the median of her breast. She is thrilled by her new shape and size, and all of her symptoms have resolved! Although scars typically continue to fade for 2 years or longer, we have had her using topical silicone and they are already fading well.
A Hispanic male in his early 30’s with breast development in his early 20’s after taking weight lifting supplements. He is bothered by the appearance of his chest with his shirt off
He is shown before and again, 5 months after bilateral gynecomastia surgery with liposuction using the S.A.F.E. technique ( Separation Aspiration Fat Equalization) combined with excision of breast tissue from an incision around the areola. Scars get thicker for 6 weeks and then soften and fade over the next 12 months or longer. At 5 months the scars continue to fade well with the recommended use of topical silicone and he is thrilled with his new contour.
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.
Breast Augmentation Revision with Ideal Implants – Patient 314
Breast Augmentation Revision with Ideal Implants – Patient 314
A woman in her later 40’s with breast ptosis and deflation of her left breast implant.
She had breast augmentation 20 year before by a different plastic surgeon and noticed a sudden decrease in the size of her left breast 2 weeks before seeing me. She describes herself as a 36 D cup an d wa happy with the size. Since her breast augmentation she has had 2 children, which she breast fed, and her breasts have become “droopier” in appearance. Her implant information was obtained and she had Mentor 300 cc textured implants placed through a transaxillary incision and in a subglandular space. She is active at the gym and likes the lack of animation with a subglandular placement.
She is 5’9” and 167 lbs Sizing was done in the office and she elecdted for a slight increase in size. She is shown 11 months after bilateral implant removal, capsulotomy, and replacement with Mentor Smooth round moderate profile saline 400 cc implants ( 350-400 filled to 400) combined with a periareolar mastopexy using a Round- block Goretex suture. A separate inframammay incision was used to remove her old implants and place the new implants.
Mentor no longer makes a textured saline implant and the smooth surface was used.