Breast Gallery

A challenging case in a woman with small breasts and a tight skin envelope, as well as pectus excavatum ( a hollow depression in the chest bone) who wishes to have a natural appearance. When the chest wall is sloped, the implant will tend to migrate “down the slope” towards the middle with time. Therefore we selected textured, cohesive silicone round gel implants. When the tissues are tight the implant needs to be even more precisely matched to the patient. She is 5’5” and 120 lbs and is shown before and again, 22 months after partial subpectoral placement through an inframammary incision. 305 cc Sientra implants were used. Tattoos are blurred for privacy.

A man in his early 30’s who is bothered by female breast development. He did not finish growing in height until his sophomore year of college. He noted female breast development starting after college. His endocrinology workup was normal and he does not have a testicular mass on the examination by his physician. He is bothered by the appearance of his chest with his shirt off but also in some shirts. He did not have a history of significant marijuana use or anabolic steroids. The cause of his gynecomastia is “idiopathic” which is a fancy word for unknown.
He is shown before and again, 5 months after power assisted liposuction with external ultrasound assist using the SAFE technique ( Suction Aspiration Fat Equalization) combined with direct excision of breast tissue through a peri-areolar incision.

At 10 months, our patients scars have continued to fade. Hands on head view shows perfect contour of the chest from the S.A.F.E. liposuction combined with the direct excision. It may be tempting to consider only a direct excision without the S.A.F.E. technique- but in my experience it is difficult to perform a direct excision without the liposuction and obtain a smooth surface as we have done here. Even when there is not a large amount of fat, the undermining with the special cannula initially helps to separate the mass of breast tissue so that is technically easier to smoothly excise it without leaving irregularities of the overlying skin. Then after the excision the fat equalization portion of the S.A.F.E. technique further smooths the overlying layer of fat. In this way we have managed to avoid contour irregularities of the subcutaneous layer.

A woman in her early 30’s who describes herself as an A-B cup and would like to be closer to the padded C cup bra that she currently wears, but still natural in appearance. She is 5’ 2 1/2” and 112 lbs and after careful sizing in the office based on her tissue measurements and characteristics a 325 cc moderate profile plus smooth round silicone gel implant was selected. She is shown before and again, 6 weeks after partial subpectoral ( below the muscle) placement of the implants through an infra mammary ( at the breast fold) incision. She is thrilled with her fuller but still natural appearance.