Breast Augmentation

Before And After Photos


This is a 21 year old 5’2″ and 130 pounds who presented to me for a bilateral breast enhancement. She is seen here after a bilateral breast augmentation with 325cc saline implants placed beneath the muscle from an incision in the crease at the bottom of her breasts. Her case was complicated by the development of stretch marks on both breasts after surgery. She is seen here about 7 months after surgery and the stretch marks are much better in terms of how angry they appear and the coloring is much lighter. She is very happy with her results although she obviously wishes she didn’t develop stretch marks.

From my analysis of her case I can clearly see that she has small, lateral breasts that sit relatively high on her chest wall. The implant size that she prefers is much larger than her the size of her breasts. This puts her at risk for the appearance of a “double bubble”. This is seen when the smaller breast appears to be sitting on the larger breast implant and appears like a smaller “bubble” on top of a larger “bubble”. Indeed, she has this appearance particularly on the left side. Her implants are soft, and her breast look pretty impressive. She told me that when her friends saw her breasts after her procedure with the stretch marks, they were in no hurry to get a breast augmentation, but after the stretch marks improved over time they felt they would have the procedure. She wears an excellent bra to keep her breasts close together so they don’t fall off to the side over time (she used to be a bra consultant at Victoria’s Secret).

Lessons to learn:

  1. Stretch marks after a breast augmentation is uncommon. I have seen 4 cases in twenty five years. We don’t know who is prone to develop them after an augmentation. In my experience, it was seen in younger women. It may be related to hormones running around in younger women. It may also be associated with birth control pills. It’s not fun if it happens, but I am always impressed how patients seem to take it in stride. It improves with time in almost all cases, but never truly goes away (it is a scar, and scars are permanent).
  2. When a patient has small breast and they prefer larger implants, the risk for a “double bubble” type condition is possible. It’s more likely in patients who have dense breast tissue that does not flatten out or conform to the breast implant as occurs in most cases.
  3. A treatment alternative to the crease that forms from the “double bubble” appearance is fat transfer to fill out this area for a smoother transition.
  4. This patient told me that she used “cocoa butter” on her skin when she developed the stretch marks. She thinks this helped a lot. There is no scientific evidence to support this treatment, but it certainly won’t hurt. It is believed that women who develop stretch marks from pregnancy are genetically prone for this to happen (this is something that runs in the family).