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Patient Details
This is a breast augmentation case that turned into a breast revision case. This is a 34 year old mother of two who is 5’3″ and 145 pounds who was initially interested in a breast enhancement and liposuction. She is seen in photo 1 before any procedures. Her right breast is larger and lower than that on the left. She was lucky that she had good quality skin and breast tissue. I decided to simply augment her breasts and perform liposuction on the right breast only in an effort to minimize scars and make her breasts more similar in size and shape. Photo 2 shows her results after an augmentation with 275cc smooth saline implants placed below the muscle from an incision in the crease at the bottom of the breast. There is an improvement in breast shape, symmetry, and superior breast fullness. You can also see how the liposuction of her trunk made this smaller.
In Photo 3 about three years later she returned to the office because she complained that her breasts were displaced laterally and they were too wide and maybe bigger than she wanted them to be. At this time she was starting to get into big time exercise and working hard to get “fit.” I think she felt her breasts were not as complimentary to the “new” woman. Although there was some lateral displacement of her breasts when she was lying down (this is certainly normal), I felt that I could adjust her breast implant pockets and move them up and towards the midline and make them appear “perkier.” I found out that she hadn’t worn a bra since her first procedure; this contributes to her breasts displacing down and out for sure.
Photo 4 shows her after the removal of her saline implants and replacing them with 250cc silicone in the same pocket after adjusting the position of the implants upwards and medially. Clearly you can see that they are smaller, narrower and fairly symmetrical. The two additional photos show the quality bra that she now wears to support her breasts and the sleeping bra that I recommend to keep her breasts from sliding to the side at night. Almost all women have a natural slope or curve to the rib cage that allows gravity to move breast implants off to the side. This tendency needs to be countered by the use of a supportive bra. She is into big time fitness now with a weight of 123 pounds and hopes to showcase her new shape in a contest.
This “patient story” illustrates the journey of a typical patient. Although she really didn’t have any “problems” or complications from her previous procedures, it was a “style” change that she desired. This is OK from my perspective as long as my patients accept that there are no guarantees that they won’t experience complications, and that these additional procedures are associated with additional costs. I smile to myself when I think that my services may have contributed to this patients apparent “life change.” This is one of the most potentially powerful attributes of plastic surgery—that ability to facilitate self improvement and the promotion of a healthy lifestyle.
