Breast Reduction with Augmentation Intraoperative
This is a 26 year old female, with no children, who is 5’5″ and 145 pounds who was interested in a breast enhancement. She told me that she could hold a “TV remote” under her breasts. She didn’t like the saggy nature of her breasts. She had done a lot of research about the advanced version of the breast lift with implants procedure I call the Breast Reduction with Augmentation (BRA) and thought that would provide her with the result that she wanted. Specifically that was superior breast fullness and no more saggy breasts.
Honestly, I thought that she had very attractive breasts as they were and I counseled her to consider doing nothing. However, she was very focused on what she wanted and was very aware of my BRA procedure so under these circumstances I felt that we can make appropriate changes in her breasts and I hoped it would make her happy.
She is seen here after a bilateral breast augmentation with 225cc smooth walled high profile silicone implants placed beneath the muscle. Very dense breast tissue (almost rock) was removed along the bottom of each breast (please see the photo of the breast tissue removed at the time of her procedure). A vertical “lift” was used to shape the breast around the implant with the final scar shaped like an anchor (except that the scar at the bottom of the breast was not as long as a typical breast reduction only procedure).
She is very happy with her result. There is a HUGE change in her breasts. There is nothing that sags and there is no way she will be able to hold up a remote under her breasts. Her areolas have widened a bit more than usual and she has some skin excess beneath the bottom of the left breast. The left nipple areola complex is a bit higher than is ideal. All these issues are not unexpected, and we discussed a minor revision under local anesthesia after about a year’s time if she wanted.
It’s a challenge performing this procedure. It’s almost never “perfect” and irregularities can occur. But often, the minor issues that I observe are of no importance to the patient for some reason. I think that if you compare the “big picture” difference between the before and after results it’s no wonder that the patients are happy with their result.
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