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Patient Details
This is a 27 year old woman, 5’10” and 135 pounds, who didn’t like the appearance of her breasts. She did not have a history of substantial weight loss (a question that was asked by many of the plastic surgeons she had seen in consultation).
Her breasts are narrow and saggy. She has little to no superior breast fullness. Her areolas have spread and are quite wide. Her skin is very thin, she has stretch marks about her breasts, and her breast tissue is lumpy and granular feeling on exam. This is not a common presentation for such a young woman with no children. This suggests that genetic factors have played a significant role in the appearance of her breasts. Regardless of the reasons for her shape, this is not a shape that a young woman feels comfortable with to say the very least.
She is seen here five years after a BRA procedure with the use of 350cc silicone implants placed beneath an uninterrupted pectoralis muscle. I reduced about 40 grams of tissue from the lower portion of each breast. At the time of surgery, I was not comfortable removing all of the areola skin because it may have made the final closure too tight and this could have resulted in wound healing problems. You can see some of the darker pigmented skin of her old areola on the face of her breasts on both sides. Also, take a look at the lines on the frontal photos. The white line goes from the bottom of her breast to a mole on her abdomen. This illustrates the lengthening of her abdomen after the advanced version of the breast lift with implants procedure known as the Breast Reduction with Augmentation (BRA). The yellow line goes from her clavicle to the top of her breast in each photo. Notice how high the new “take off” of her breasts are. She has a much shorter upper chest. This is a much more youthful orientation of her breasts – more fitting for the young woman that she is.
I plan on excising the residual dark skin from the face of her breasts under local anesthesia in the office as a minor procedure. I also recommended that she drop her implants about a finger breath for best shape on both sides (massage her implants down). She was not wearing a correct bra because she was not professionally fit and measured after her procedure (her choice, not mine). She was wearing a 36D bra when she probably needs a supportive 34DD or 34E. I know this sounds huge, but when you are professionally measured you will end up being a lot larger than you think. The “new” C is a DD.
