Breast Augmentation – Patient 279

A woman in her early 20’s who describes herself as a 32a-b cup and would like to be fuller but still natural in appearance She does not mind a slight implant look if necessary to achieve her goals in clothing. She is 5’3” and 109 lbs and is shown before and again, 6 weeks after breast augmentation with partial subpectoral placement of 300 cc Ideal Structured saline breast implants filled to a total size of 300 cc, placed through an inframammary incision.

Discussion: She was quite interested in the Ideal structured saline implant because she didn’t want to worry about “silent rupture” but wanted an implant that feels more natural than the traditional saline implant and would not have the same risk of ripples and wrinkles. All impltns whether “gummy bear”, silicone gel or saline will fail eventually- typical numbers are about 10 out of 100 (10%) have failed by 10 years. When a saline implant leaks the implant goes flat and is easily determined by looking at your breast. When a silicone gel or “gummy bear” implant fails the silicone is still contained within the capsule of scar tissue that forms around the implant and there may be no outward sign- the rupture is typically “silent”. So although the silicone gel has a slightly more natural feel, an MRI or ultrasound is usually needed to tell if the implant is still intact.
The Ideal implant has two chambers. The back/inner chamber is always filled to the same volume but the front chamber can be filled to two different volumes to give either a moderate profile or a high profile look. In her case the empty implant volume is 37 cc, the back/inner lumen is filled to 188 cc and the front/outer lumen is filled to 75 cc. So 37 + 188 + 75 = 300. This is a little confusing at first because the structured implant shells themselves have a volume. So it is important to fill these precisely according to the chart. She has a relatively “tight” breast and the moderate profile gives a more natural appearance in her case. 6 weeks is early, because the breast will still stretch a little to accommodate the implant over the next few months and appear even more natural. The Ideal implant is filled after it is placed in the breast pocket so the incision needed is shorter than that for a silicone gel implant although slightly longer than that for the old fashioned saline implant, because the empty shell does not fold quite as flat.