Breast Gallery

A teacher in her early 20’s who describes herself as a 36 H cup and has problems with back pain, shoulder pain, grooving and irritation of her shoulders form the bra straps, as well as difficulties with her posture.  She is over her ideal body weight at 226 lbs and 5’4” but is finds it difficult to lose weight because of difficulty exercising due to the size of her breasts.

She is shown before and again, 5 ½ months after bilateral breast reduction with the removal of 1852 grams of weight from her left breast and 1776 grams of weight from her right breast.  A pound is 454 grams so that is just over 8 pounds of tissue!

She is thrilled with her new shape and size, and her symptoms have resolved.  We decided upon a full C so that her breasts may still be proportional when she loses more weight.  Her scars typically will continue to fade and improve over the next 18 months or longer.

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 woman of color in her later 50’s who was bothered by a drooping appearance of her breasts and also has some back pain with a 38 DD cup. She wanted to be lifted but only a little smaller.   She is 5” 2 ½” and 158 lbs and is shown before and again, just 7 weeks after a bilateral reduction mastopexy with the removal of 325 gms of tissue from each breast.  This is a nearly followup as scars are typically at their worst at 6 weeks and then continue to soften and fade over the next two years.  She is thrilled with her new shape and size.  She did not want to have her lucky mole removed between her breasts.

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 40’s with 40 DDD cup bra who has problems with grooving and irritation of her shoulders, back pain, shoulder pain, difficulty exercising. She likes to walk or run 5 times a ay and needs to wear at least double bras to do this. She is 5 ‘ 5” and 183 lbs and is shown before and again, just 4 months after bilateral breast reduction with the removal of 766 grams from her right breast and 743 grams from her left breast to reduce her to a C cup. Her symptoms have resolved and she is thrilled with her new shape and size.

A woman in her later 50’s with 36 triple D bra who had trouble with sports, back pain, grooving and irritation of her shoulders from the bra straps, difficulty with her posture and embarrassment due to the size of her breasts in clothing. She is 5’6” and 162 lbs and is shown before and again 8 months after bilateral breast reduction with the removal of 660 grams of tissue from her right breast and 745 grams of tissue from her left breast to reduce her to a C cup. Her symptoms have resolved and she is thrilled with her new shape and size

A man in his late teens with gynecomastia since the age of 12. He is shown before and again, 6 weeks after bilateral gynecomastia treatment using the S.A.F.E. technique ( Separation Aspiration Fat Equalization) with power assisted liposuction with the removal of 500 cc of lipoaspirate from each side of the chest combined with the direct excision of 30 grams of tissue from the right breast and 40 grams from the left.
He is pleased with his early result. Scars are typically at their thickest and reddest at 6 weeks and will then soften an fade over the next 2 years.

Update: Our patient is now seen 4 ½ months after surgery.  Scars have continued to fade and he is pleased with his normal contour.

A woman in her mid 20’s with back pain, shoulder pain, grooving and irritation of the shoulders from her bra straps, difficulty exercising because of the size of her breasts and a rash in the warmer months. She was wearing a 34 DDD Bra. She is shown before and again, 4 ½ months after bilateral breast reduction with the removal of 743 grams from her left breast and 561 grams from her right breast to bring her down to a C cup. Her symptoms have resolved and she is thrilled with the new shape and size of her breasts.