Breast Gallery

A mother of 4 in her late 30s who has also lost 30 lbs and feels that her breasts look deflated.  She describes herself as a 36 B and wishes to be fuller but still natural in appearance.

She is shown before and again, nearly 4 months after bilateral partial subpectoral placement of Sientra 440 cohesive round smooth high profile silicone gel implants through an inframammary incision

Discussion: Her case is challenging to give her the fullness that she wants but still have a natural appearance. The base width of her existing breast is 14 cm which means that she can accommodate a silicone gel implant 14 cm or slightly wider without having an “implant look”.  But her IMF ( inframammary fold) to nipple distance on stretch is only 8 cm which typically accommodates a 12 cm base width implant.  After sizing in the office she liked 425 and 450 cc implants.  The Sientra 10621-440 HP is 12.8 at the base.  Although this is slightly wider than the ideal 12.0 base that “fits” more easily, I reinforced her folds at the time of surgery with long-lasting absorbable sutures to help the inframammary fold ligaments remain intact while the lower pole of the breast stretched slightly to accommodate the new implant.  We were able to avoid “bottoming out” and/or a “double bubble” that can happen when a fold is released and lowered.  She has a natural, proportional look that balances with her body and appears natural.

A man in his mid 20’s with female-appearing breasts that started at the age of 12 (idiopathic gynecomastia)

He is shown before and again, 5 ½ months after gynecomastia treatment with power-assisted liposuction combined with direct excision of breast tissue through an incision along the lower areola.  He is thrilled with his new correction and his skin has contracted well, in large part due to his younger age.

A woman in her early 20s with breast asymmetry since she developed breasts at the age of 11.  She feels that her right breast is uncomfortably large when she runs and would like both breasts to be smaller and to match more closely.  She is shown before and again, 11 months after bilateral breast reduction with the removal of 268 grams from her right breast and 119 grams from her left to reduce her to a small C cup. She loves her new shape and size and no longer has issues with being uncomfortable when she runs.

A woman in her mid-30s who had breast reduction with us at the age of 20, and was reduced from a DD to a C cup. She did well after surgery but her weight has fluctuated up and down since.  She is back to her normal weight but now is a 32 DD and again feels out of proportion and is having some shoulder irritation from her bra straps.

She had a secondary breast reduction including liposuction of axillary lipodystrophy ( mild fat bulges in the armpit area) and is back to a C cup after the removal of 163 grams from her right breast and 160 grams from her left breast.

A man in his late 60s who has been bothered since he was a teen by the prominence of his nipples which shows in many shirts.  He also has gynecomastia but this does not bother him as much.  He is shown before and again, 3 months after bilateral nipple reduction in the office.  He is thrilled with having corrected an issue that has bothered him for so many years, and can now wear fitted shirts and t-shirts without feeling self-conscious.

An Asian woman in her later teens is bothered by back and shoulder pain and difficulty exercising due to the size of her breasts, which she describes as a 34 DD cup.  She is 5’4” and 120 lbs and is shown before and again, 8 months after bilateral breast reduction.  Scars typically will get thicker for 6 weeks and then will fade and improve over the next 2 years.  We have had her use topical silicone to help with scar maturation.  Her symptoms have resolved and she is thrilled with her new shape and size.

An early, 6 week, follow-up on a woman in her mid 20’s after breast augmentation.  She was a 30-32 A-B cup and wanted to be more proportional.  She did not mind having some superior pole convexity ( fullness in the upper breast) but did not want an overly round, “Implant” look

She is shown before and again, 6 weeks after bilateral partial subpectoral placement of smooth round Sientra high profile cohesive silicone implants 225 ml placed through an inframammary incision.

Discussion: While this may not seem to be a very large implant, it is the largest that I feel we can use for this patient and still maintain a relatively natural result. She is petite at 5’3” and 117 lbs and her optimal bra band size is just 31”   Her breast base width is 10.35 cm on her right and 11.4 cm on her left.  Her IMF –N ) Inframammary fold to the nipple) distance on the stretch is 5.5 cm on her right and 7 cm on her left

The Sientra 225 high projection implant is 10.2 cm in width.  This fist is within her existing base width of 10.35 cm so it won’t look overly round once her tissues have settled.

To avoid excessive fullness above the nipple level, we might select a 9.5 cm base width implant to have the nipple centered.  Because she does not mind some superior breast fullness we can use a slightly wider implant ( 10.2) anticipating that the lower portion of the breast will stretch with time to accommodate the new implant.  Her existing Inframammary fold ligament was reinforced at the time of surgery by anchoring it to the deep tissues with long-lasting dissolving sutures- this decreases the risk of the existing fold “giving out” and the breast bottoming out.

A man in his mid-20s with idiopathic gynecomastia, who developed female-appearing breasts at puberty.  Ha is bothered by the appearance of his chest but also how it “feels” when he is working out.

He is shown just before and again, 5 months after Power-assisted liposuction using the S.A.F.E. technique combined with direct excision of breast tissue through a peri-areolar incision.  Scars, which are typically thicker for 6 weeks and then improve over the next 2 years are fading nicely.  The “hands-on head” view demonstrates shows the gynecomastia well before and after the surgery.  The areolas have decreased in diameter with the removal of the excess breast tissue.

His contour is now excellent but he also no longer has the discouraging feeling of extra breast tissue on his chest when he is working out.

An Asian woman in her late teens who was a 34 DD cup and had problems with exercise, especially with her preferred sport of swimming.  She had trouble finding bras to fit as well as problems with back and shoulder pain.  She is 5’ 4” and 120 lbs and is shown just before and again, 5 months after bilateral breast reduction with the removal of 385 grams of breast tissue from her left breast and 471 grams of tissue from her right breast to reduce her to a “C” cup and balance the size of her breasts.  Scars will typically continue to fade and improve for 2 years or more after surgery.  She is thrilled with her new shape and size, and her symptoms have all resolved.

A woman in her late teens with bilateral macromastia and axillary lipodystrophy.  She was bothered by neck, back, and shoulder pain.  She is 5’ 3” and 178 lbs and is shown before and again, 8 months after bilateral breast reduction including liposuction,  with the removal of 780 grams of breast tissue from each side, and 700 ml of lipo-aspirate from each lateral breast and axilla.  Her symptoms have resolved and she is pleased with her new shape and size.