Breast Augmentation with IDEAL IMPLANTS Gallery

An athletic mother of 2 in her later 30s who is bothered by the deflated appearance of her breasts after pregnancy and would like to be fuller.  She describes herself as an “AA cup”

She is shown before and again, 6 weeks after bilateral partial sub-pectoral ( below the muscle) placement of Idea Structured Saline implants placed through an inframammary ( at the breast fold) incision.  Breasts will continue to soften in appearance with Ideal implants for the next 3-4 months.  She is thrilled by her fuller but still natural appearance.

Discussion:  Pt is 5’4″ and 149 lbs

Her distance from the infra-mammary fold (IMF) to the nipple on stretch is 9 cm on her left and 9.5 cm on her right.  Putting tension on the skin estimates how much length we have to accommodate the weight of an implant.

The width of her breasts is 13 cm each.  So with the Ideal breast implant, we need to size down 3 mm to account for the curved base of the Ideal implant, so the largest that we can use without giving an implant look would be a base width of 12.7 cm.

Upon sizing in the office she liked a size of 375 and felt that 400 was simply too full a look in clothing.

So our plan that we proceeded with was to use the Ideal Structured Saline 370-415 filled to 375 which gives an equivalent  base width of 11.8 plus 0.3 = 12.1

She had had a history of Methicillin-resistant Staph at the gym two years before so we tested her and got a negative test before surgery to decrease the risk of infection.

Because the implant base equivalent at 12.1  is less than her breast base of 13 cm it does not “look like an implant”  The left breast implant looks just a little fuller in the upper breast because the IMF to fold on stretch is a little less on that side.  This will settle out over the next few months as the breasts stretch to accommodate the implant.

A nurse in her mid 30’s who has some breast asymmetry after the removal of 2 benign tumors from her left breast, would also like to have breasts that are fuller and more proportional to her frame.  She is 5’10” and 157 lbs and wears a 34 B cup bra.  She is shown before and again, 6 weeks after the bilateral partial subpectoral placement of Ideal Structured Saline implants filled to 415 ml

Discussion: her nipple to Inframammary fold on the stretch is 8.5 cm and the base width of her breast is 12 cm.  The ideal implant 370-415 when filled to 415 has a base width of 11.7 which is equivalent to a base width of 12 cm.  The ideal implant is curved to fit the chest wall and we add 3 mm to the width and subtract 3 mm from the projection to match the equivalent standard implant. She wanted to have a natural look, and when the Ideal implant  Is wider than the existing breast base it can look overly round or “implant” like in appearance.  A nipple to IMF on a stretch of 8.5 cm would have allowed an implant base of 12.5 cm from the standpoint of keeping the nipple centered on the implant but is wider than her measured base width would suggest. The same size was used on each side because the difference in size was not enough to suggest different-size implants which would have a difference in projection and not appear as symmetric.

She loves her natural look after surgery and finds that her top is now in balance with her hips.  The Ideal structured saline implant also gives the peace of mind of not having to worry about silent ruptures.  She will see a change in size if one of the 2 chambers should fail.    A silicone gel implant rupture on the other hand is typically “silent”, or not noticeable on the outward appearance of the breast.  The FDA recommends that patients with silicone gel implants obtain an ultrasound at 6 years and then every 1-2 years after that.  The six-year recommendation is because the risk of a spontaneous rupture is very low before that point.  Ultrasound has been shown now to be a good screening tool for implant rupture and is significantly less expensive than an MRI.

A medical professional in her early 30s who would like to have fuller breasts, but still have a natural appearance.  She is shown before and again, 6 weeks after bilateral partial subpectoral breast augmentation with Ideal structured saline implants filled to a total of 375.  An inframammary fold incision was used.

Discussion:

The width of her breast is 11.8 cm, and the Inframammary fold  to nipple distance on the stretch is 8.5 cm on her right and 9.5 cm on her left

The Ideal implant 335-375 when filled to 375 has a base width of 11.3.  We add 0.3 m to the base to give the equivalent base of a typical “flat” implant, as the Ideal implant is curved at the base to fit the chest wall. So 11.6 is less than her measured base of 11.8 and will not give her an overly round “implant” look, which she did not want.

We sized her in the office with the mentor sizing system and she did not want to be larger than 375 cc, as fuller implants looked too large to her in clothing.  We used the Ideal Structured saline implant 335-375, with the posterior chamber filled to 188 ml and the front chamber to 135 ml.  Together with the empty implant volume of 52 ml, this gives a total volume of 375

The next larger size of the Ideal implant of 375-415 would have had an equivalent base of 12( 11.7 plus 0.3 cm) and would have exceeded the natural width of her breast and tend to look unnatural and, although fuller in clothing would look like an implant. The Ideal implants are a little stiffer than silicone implants and I can go a little larger with a silicone gel implant and still look natural.  This was a moot point in her case as she did not like a fuller look in clothing, in any event.  If she had wanted to be bigger we would have to discuss the tradeoff of not having a natural look or switching to a silicone gel implant, neither of which she wanted.

A medical professional in her late 20’s who describes herself as a 36 B cup.  She describes herself as a “tomboy” and “athletic body” in high school and college.  She has been attending a lot of weddings and does not feel “feminine” and would like to have breasts that are fuller but still natural in appearance.  She is shown before and again, just 6 weeks after the placement of Ideal Structured Saline Implants in a partial sub-pectoral ( “under the muscle” position through an infra-mammary ( at the breast fold) incision.

Discussion:

She  is petite at 5’ 1 ½” and 126 lbs.  She viewed photos in the office and wanted an absolutely natural appearance without any implant roundness or superior bulging ( “superior pole convexity)  He nipple to fold distance on stretch is 7 ½ cm and her breast base width is 11.4 cm.  With the Ideal implant, which is curved to fit on the curved surface of the chest wall and not flat as with most  other implants, we typically add 3 mm to the base so an 11.1 cm base or less will “fit” but not be wider than her existing breast and not give an overly round or “implant” look So the Ideal implant 270-305 is 10.6 cm( remember to add 3 mm for an equivalent diameter of 10.9 cm0  at the base when filled to 305.  She could have considered the next size up which is 300-340 and 10.8 cm at the base ( equivalent of 11.2 cm) but this was much too large to her in the office during a sizing appointment.  So We used the 270-305.  The back lumen or chamber  is filled to 165 ml and the front or outer lumen is filled to 105 ml and with the empty implant volume of 35 ml gives a total implant volume of 305 ml

At 6 weeks she is already thrilled with her result- we can expect the breasts  to continue to soften in appearance as the tissues stretch to accommodate the implant over the next few months and appear even more natural.

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 mother of one in her early 50’s who has a long standing deflation of her left saline implant. She originally had 275 cc smooth round mentor saline implants placed in a partial sub-pectoral position through an infra-mammary incision in 2007. She did well but 3 years ago had a spontaneous deflation of her left breast implant.

She is petite at 5’2” and 118 lbs and elected for a small increase in size. She is now 6 weeks after removal of her ruptured left implant and intact right implant, using the same incisions and replacing with Ideal Structured Saline implants 300 filled to the top recommended total volume of 340.

A woman in her early 20’s who is a 32A cup and wished to be a full b or small c if possible. She is very thin at 5’7” and 101 lbs and a BMI of 16.06. Her case is also complicated by a pectus excavatum, which is a depressed hollow of the sternal area. In very thin patients I like to have them supplement their nutrition with an additional 80 gms of protein a day for a months before and after surgery. She had a nipple piercing when she first came in and I have recommended that she not replace this after surgery to decrease the risk of capsular contracture. There is bacteria in the nipple ducts, and any trauma can allow this bacteria to get into the blood stream and potentially travel to the implant, with the resultant biofilm potentially leading to a capsular contracture. The base width of her breast is 9.8 cm. The nipple to fold is 5 cm and increases on stretch to 6.5 cm. She is shown before and again, 4 months after bilateral subpectoral placement of Ideal Structured saline implants 210-235 cc filled to 235 cc. The empty implant volume is 30 cc. The back/inner lumen is filled to 120 cc and the front/outer lumen is filled to 85 cc to give the total of 235 cc. The breast fold was reinforced by anchoring it temporarily to the rib periosteum with long lasting but dissolving sutures to prevent “bottoming out” of the breast.
The dimensions of this implant are 9.7 cm but we add 0.3 cm because it is measured on a curved surface to give a base equivalent of 10 cm. The projection is 4.4 cm. The equivalent diameter is 0.2 cm larger than her native breast and can therefore give a slight implant look which she was ok with. She wanted the Ideal implant which is filled with saline and this is the smallest size that the company makes, but just fit. If she had wanted to be any fuller I would have recommended that she switch instead to a silicone gel implant which can allow a slightly fuller implant to be used.

She is thrilled with her fuller, but still natural appearance. Tattoos have been blurred for her privacy.

Update: She is now seen 9 months after surgery. The breasts have settled in appearance and appear even more natural.

A mother of 3 in her mid 30’s who is bothered by a deflated appearance of her breasts after pregnancies and breast feeding. She describes herself as an A cup and would like to be a C cup. She did like the appearance of her breasts after they were enlarged for breast feeding. She wished to have a natural appearance after surgery and liked the idea of the Ideal structured saline implant so she would have the peace of mind of not needing to worry about a silent rupture. She is shown before and again, 7 weeks after surgery with an Ideal implant filled to 340 cc on her right (maximum fill) and 300 on her left (minimum fill) to balance her asymmetry.

Discussion:
On a sizing visit, she liked the 300/325 size. She felt the 325 was “a little full but she could live with it”. The base width of her breasts are 11.6 cm on her right and 11.4 cm on her left. Her nipple to fold distance on stretch is 8 cm on her right and 8.2 cm on her left.
The Ideal Structured Saline implant 300-340 was chosen and was placed through an inframammary incision and underneath the pectoralis muscle. The base of the Ideal implant is 10.9 cm but because it is curved we add 0.3 cm to give an 11.2 cm equivalent. So we can be confident that it will “fit” the base of her existing breast and not give an overly round “implant” look that she did not desire.