Breast Augmentation Revision/Ideal Implants – Patient 292
A woman in her mid 20’s with a tuberous breast deformity. She is bothered by the shape and also the size of her breasts. She wanted to be fuller but still natural in appearance. With a Tuberous breast, the base of the breast is relatively constricted and narrow and needs to be expanded. The breast is overly “pointy” and needs to have the shape flattened a little. A periareolar round block gortex suture flattens a tuberous breast and improves the shape. She is 5’5’ and 132 lbs but the base width of her breast is just 10.7 cm on her right and 10.5 cm on her left. The inferior areola to the breast fold distance is just 5 cm. So an implant needs to be carefully chosen that will widen the base of the breast but not be too large for the new nipple to breast fold distance which with reduction of the areolar with a gortex suture would be 7 to 7.2 cm. This would suggest based on the geometry that an implant with a base width of 11-11.2 cm is the widest that can be used without needing to lower her breast fold. Lowering the fold increases the risk of “bottoming out” and also of a “double bubble”.
She elected for the Ideal structured saline implant and so the 300 cc implant was selected. This has a base width of 11.1 cm so it is just a little wider than the base of her existing breast which helps to widen the base of the breast, but is not too large for her new nipple to fold distance after her periareolar round block suture is placed. The implant was placed in a subglandular plane.
The 300 cc implant has an empty implant volume of 37 cc due to the internal baffles, and the back/inner lumen is designed to be filled to 188 cc. The front lumen can be filled to 75 cc to give a moderate profile and total volume of 300 or to 115 cc to give a high profile and a total volume of 340 cc.. In her case a moderate profile has a better effect and the implant was filled to 300 cc total volume. She is shown before and again, just 3 months after surgery.
The scars around the areola will typically continue to fade and improve over the first 2 years after surgery. She is already thrilled with her new shape and size. It would have been difficult to use a larger implant in her case and still maintain a natural appearance because of the tissue dimensions of her breast.
Breast Augmentation Revision/Ideal Implants – Patient 291
Breast Augmentation Revision/Ideal Implants – Patient 291
A mother of 3 in her early 30’s who had subglandular breast augmentation with saline implants 9 years before through a trans-axillary incision. She has had her 3 children since that time and would like her breasts to be fuller and more like they were before children. She is also bothered by visible and palpable wrinkles, especially in the cleavage area and upper breast when she leans forward. She is 5’5 and 127 lbs and wears a 32 cup bra.
She is shown before and again, 6 weeks after replacement of her saline implants with Ideal Structured Saline implants 370-415 filled to 415 cc total volume and placed in the original sub-glandular position though an inframammary incision.
Discussion: She already has some stretching of the lower part of her breast which is at 9.5 cm from the infra-mammary fold to the nipple. Her breast tissues are relatively thin with a caliper pinch of 2 cm. She had her implant card which showed Mentor moderate profile 275-300 cc implants filled to 300 cc. The base of this implant is 11.7 cm and it projects 4.3 cm She was sized in the office by adding Mentor sizing shells to her existing volume and she liked the addition of 125 cc but 150 cc started to look too full for her petite frame. In addition, the larger the implant, the more weight related stretching of the breast tissues so we elected for the 415 cc size Ideal structured saline implant, which is similar to a high profile silicone implant. In the case, the empty implant volume is 56 cc and the inner/back lumen is filled to 214 cc and the front/outer lumen is filled to 145 cc to give the total volume of 415 cc. This Ideal implant has a base of 11.7 when filled to 415 and has a projection of 5.3 cm. So is fits the space of her old implant but does not require any modification of the lower breast implant capsule- we can preserve the capsule to help support the new implant and help to protect her tissues from more stretching. She could have changed to a silicone gel implant to have less ripples and wrinkles but did not like the idea of a possible silent rupture- she liked being able to detect a leak with the saline implants on exam. She was changed to the Ideal structured saline implant and loves the new feel. She says that the wrinkles and ripples are nearly gone and do not feel like “a baggy filled with water” like her old implants. The higher profile gives a little more fullness in the upper breast.
A woman in her mid 40’s who has lost 70 lb with diet and exercise and would like her breast to be fuller. She described herself as a 34B cup and wanted to be a C to full C cup. She was fearful of silicone and silent rupture and wanted saline implants. She is 5’6” and 134 lbs. Sizing was performed in the office based on her tissue dimensions and using the Mentor sizing shell system. She liked an implant size around 400 in clothing and felt that 450 was too big.
She is shown before and again, 9 months after bilateral partial subpectoral (below the muscle) placement of Ideal Structured Saline 370-415 cc implant filled to 415 ( the equivalent of a high profile implant) placed through an inframammary incision ( at the breast fold). She is thrilled by the fuller but still natural appearance of her breasts.
Tattoos have been blurred for her privacy. The photos are otherwise untouched.
A woman in her early 20’s who wants fuller breasts but still natural in appearance. She is concerned about silent rupture and has elected for the Ideal structured saline implants.
She is petite at 5’3” and 109 lbs and wore a 32 A to B cup before surgery. She is shown before and again, 4 ½ months after bilateral partial sub-pectoral breast augmentation with the placement of the 300cc Ideal structure Saline implant filled to the 300cc total volume. The empty implant is 37 cc, and the back/inner lumen is filled to 188 cc and the front/outer lumen is filled to 75 cc to give the total volume of 300 cc.
A 20 yo woman with breast asymmetry who wished to be more symmetry in and out of clothing. She is 5’6” ‘and 149 lbs. She has elected for the ideal structured saline implant and is shown before and again, 7 weeks after bilateral partial subpectoral placement of the Ideal implants through an inframammary incision. She has a 370 cc implant filled to the “high” volume of 370 on her right, which is actually similar to a moderate profile implant in profile and a 210 cc implant filled to 235 cc on her left which is closer to the “100%” and more similar to a high profile implant in profile. The right breast, which is the smaller of the two breasts will tend to have more superior pole convexity, or fullness of the upper breast because it is relatively tighter. So to balance the upper pole fullness between the two breasts, a higher profile is used on the left, but, of course, a smaller implant to better balance the size.
Update: Our patent is now seen 5 months after her surgery. The breasts have softened in appearance as the breast tissues stretched to accommodate the implants.
A mother of 3 in her late 30’s who feels like her breasts are too small to balance her frame, and is also bothered by breast asymmetry in a bathing suit and in T shirts when she is not able to wear a padded bra to camouflage. She has selected the ideal structured saline implants because she didn’t want to worry about silent rupture but wanted an implant that feels more natural than the traditional saline.
She is 5’6” and 138 lbs and is shown before and again, 6 weeks after bilateral partial sub-pectoral breast augmentation through and inframammary incision with a 300 cc Ideal structured saline implant on her left filled to 320cc which is above the “high” but below the “100%” fill volume, and a 440 cc Ideal structured saline implant on her right filled to the “high” of 440 cc. Tattoos have been blurred for her privacy.
Update: At 5 months the breasts have softened in appearance
An Asian women in her early 20’s who wished to have fuller breasts but still natural in appearance. She is shown before and again, 6 weeks after 375 cc Ideal structured saline implants placed through an inframammary incision below the pectoralis muscle. She is 5’3” and 123 lbs.
Discussion: She is petite with a 32 A cup before surgery. She selected the Ideal structured saline implant because she is concerned about silent rupture but wanted a more natural feel than the typical saline breast implant. The Ideal structured saline implant has two chambers and can be filled to two different profiles. In her case this is a “335” filled to 375 cc which is the “100%” which is equivalent to a high profile implant. This allowed us to use the fullest implant in her relatively narrow chest and breast
A woman in her mid 50’s is shown before and again, 6 weeks after bilateral partial subpectoral breast augmentation combined with an inferior fold mastopexy. She is 5’3” and 112 lbs and had a nipple to fold distance when manually stretched to simulate the weight of an implant of 11 cm on her right and 10 cm on her left. As a general rule, if this distance is more than 9 cm it is better to remove some excess skin. The new breast fold was also anchored to the rib periosteum to strengthen the new fold and decrease the risk of the implants “bottoming out” and dropping inferiorly. She chose the ideal structured saline implant because she was concerned about silent rupture with silicone but wanted an implant that feels more natural than the traditional saline implant. After careful sizing based on her tissue dimensions she selected a 370 cc -415 cc Ideal structured saline implant filled to “100%” of 415 which gives a high profile.
Update: Our patent is now seen 5 ½ months after her surgery. The breasts have softened in appearance as the breast tissues stretched to accommodate the implants.
A woman in her early 30’s who wished to have fuller breasts. She described herself as wearing a padded B cup bra and wished to be a C cup without the padding. She had initially seen us two years previously and was not comfortable with the implant choices available at the time. She chose the Ideal breast implant once it was available, because it has a more natural feel than the traditional saline implant but without the risk of a “silent” rupture. It appealed to her to be able to follow her implants after surgery by simple observation rather than with ultrasound or MRI which is needed to detect the failure of a silicone gel implant.
She is 5’5” and 131 lbs and selected a 270 cc implant in the office. She is shown before and again, 6 months after partial subpectoral placement of 270 cc Ideal structured saline implants through an inframammary ( at the breast fold) incision. She is thrilled with her fuller but still natural appearance. The Ideal implants have two lumens and can be filled to give either a moderate or a full profile look. In this case the 270 is similar to a moderate profile standard saline implant in projection. It could also be filled to 305cc to give the equivalent of a high profile.