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Patient Details
This patient is 5’4″ and 114 pounds. She came to me from out-of-state desiring a breast augmentation. Upon analysis of her breasts, I noted that she had a long upper chest relative to the position of her breasts. Her breasts were asymmetrical with high nipple-areola complexes on both sides. She has scoliosis of her spine (curvature) and rib asymmetries as well. She has significant sloping of her ribs on both sides (her breasts don’t sit on a flat surface, her ribs drop off at nipple level so that her breasts sit on a hill rolling down to the underarm area).
She clearly wanted larger implants than I felt was in her best interest. My concern is that because of her long upper chest, relatively lax tissues and lateral sloping of her chest that there would be a high probability that over time her implants would move down and laterally because of gravity. A smaller implant would be less likely to experience this problem. Because she insisted on a larger size, I modified the plan a bit. I chose a textured (not smooth but rough surface) implant that I hope would “stick” a bit and be less likely to stretch the pocket and result in implant displacement.
She is seen here at four months after a bilateral augmentation with 390cc textured saline implants placed through an incision at the bottom of the breast. Her breasts are sitting perfectly on her chest wall and are soft, although they don’t move much. She is extremely pleased with her result as she enjoys the size and the shape (particularly the superior fullness). She says that she is much more confident when she doesn’t have her clothes on and that she really looks much better in a bathing suit now. As always, an excellent supportive bra is critical to her success.
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