Breast Augmentation

Before And After Photos


This is a 30 year old mother of two who is 5’5″ and 112 pounds who presented to me for a breast enhancement. She has lost all her volume, and her breast skin is quite loose. She has breast ptosis or sagging. She has a small physique. We discussed options in terms of an augmentation and lift or an augmentation alone. It was quite evident that she was interested in larger sized breast implants. We eventually decided on the use of 400cc high profile silicone implants. She is seen here about one year after surgery.

She tells me that her breast are not as large as they used to be, that she wishes she had more cleavage and that she is interested in larger implants. From my perspective, this is a nice result considering what we started out with, I have some reservations about the use of larger implants, and the reason why she doesn’t have as much cleavage as she would prefer is because her implants are sitting off to the side a bit and the bra she is wearing is not particularly supportive. She is liking the “look” of the 600cc implants.

What we can learn from her case:

  1. Women with separated breasts will not garner as much “cleavage” from a breast augmentation compared to those whose breasts are closer to start with. You can actually create cleavage by moving your implants to the midline and expand the muscle and pocket in the central area of the chest. This requires working the breast implants towards the midline and oftentimes someone other than the patient needs to do this work to achieve the goal.
  2. She has a loose skin envelope (look at her pre-operative photo with her hands up-you can see the wrinkled skin). Putting in implants in this weak skin envelope may overwhelm the ability of the tissues to support the implant resulting in additional stretching of the skin and lowering of the breast. Going with larger implants is not necessarily the way to go in her case, but, it can be done if she supports her implants well.  Silicone implants will fare much better in her case than the saline variety. The saline variety will be easily seen and felt beneath her thin tissues and rippling will be evident for sure.
  3. I am going to adjust her implant pockets so that the new implants move more medially on her chest. If she doesn’t wear an excellent bra day and night to keep them “up front” , the new pair will settle off to the side as well over time.