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Patient Details
This mother of two, Asian who is 5’2″ and 110 pounds was interested in a breast enhancement. She is small in stature and her breasts are small as well. She is seen here in sequence after a bilateral breast augmentation with 315cc smooth saline implants placed beneath the muscle from a small incision in the crease beneath the breast. She required a breast revision of her enhancement.
This is a case that I performed and I predicted that she would be more difficult and that this outcome was a distinct possibility. As she is quite small, choosing such a large implant simply doesn’t fit her dimensions. It’s like sitting two people on a seat for one. If the implants are too large for the “foundation” then the only place they can go is off to the side. If they don’t go off to the side the possibility of symmastia is a distinct possibility. This means that the breasts meet in the midline and the skin is lifted off the breast bone area and the breast cleavage becomes suspended. Essentially, the two implants meet each other across the midline!
In her case she developed asymmetry of her implant positioning. The right breast didn’t drop like that on the left. She has a mild form of symmastia. I took her back and adjusted the pockets. Which side do you think I adjusted? In other words, should I lower the right implant to match the left or raise the left to match the right? Note that the left breast has more of a natural appearance with less superior fullness and the right looks quite good and has more superior fullness (because the implant sits up higher). In her case, and many like hers, most women prefer the right breast with more superior fullness so in her case I elevated her left breast to match the right!
The moral of the story is that size selection is important because choosing an implant that is too large can lead to a number of problems that will result in issues that will eventually need to be dealt with. This is why I may choose not to offer a procedure to a patient if I feel there is a high possibility that the outcome will be compromised because they want something they don’t realize is not in their best interest.. It’s not always about giving a patient what they want. Oftentimes it’s about offering a patient a procedure that is best for them-even though they may not know it! Comprehensive education always helps to ensure that patients make the right decision. I help NUDGE them into making the right decision.
