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IDEAL BREAST®

BREAST AUGMENTATION

BEFORE AND AFTER PHOTOS

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Mentor implants-made in the USA
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Mentor implants-made in the USA

INTRODUCTION

 

 

Why Have a Breast Augmentation?

 

Studies show that one-third of all women are dissatisfied with the appearance of their natural breasts. Can a breast augmentation change this?

 

To better understand how well breast augmentation was meeting our patients’ expectations, we conducted a survey among 225 consecutive patients. Breast self-consciousness dropped from 86.2% to 12.6%. Remarkably, over 90% of women report an improvement in self-esteem after breast augmentation. No other cosmetic surgical procedure can match breast augmentation for patient satisfaction (98.1%). In our survey, the average result rating was 9.3 out of 10 on a scale of 1–10 and the median rating was 10, meaning that over half of patients scored their result a perfect 10 (!) and 98.7% of patients would do it again. (Swanson E. Prospective outcome study of 225 cases of breast augmentation. Plast Reconstr Surg. 2013;131:1158–1166.)

 

Breast augmentation with implants is arguably the most important advance in the history of cosmetic plastic surgery. It is also one of the most satisfying procedures for both the patient and surgeon in its almost magical ability to transform human shape. Gratification is almost immediate. It is an operation that reliably meets expectations (and exceeds them in almost half of patients). While rejuvenation of the face and body faces practical limitations, even older women can enjoy youthful looking breasts with the right combination of implants and lifts. No wonder this is a favorite procedure for cosmetic surgeons.

 

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DR. SWANSON OFFERS A COMPREHENSIVE RANGE OF COSMETIC PLASTIC SURGERY PROCEDURES IN KANSAS CITY AND THE SURROUNDING AREAS INCLUDING:

 

 

 

 

 

 

 

 

 

Breast augmentation prices at the Swanson Center in Kansas City include the costs of anesthesia and a licensed on-site ambulatory surgery center.

 

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What Is the Ideal Breast?

 

Smaller or larger? Full cleavage or subtle cleavage? Pendulous or perky? More fullness in the upper pole or the lower pole?

 

Among patients presenting for a breast augmentation, there is a consensus. Most women prefer more fullness in the top part of the breast. This is despite the fact that the normal breast typically is fuller in the lower pole. (Hsia HC, Thompson JG. Plast Reconstr Surg. 2003;112:312–320). We should not be too surprised, in view of the purpose of bras and corsets before bras, meant to augment the upper poles of the breast. Few, if any, Greek statues portray a sagging or deflated breast!

 

A ratio of 45:55 (or 0.82) has been recently promoted in the plastic surgery literature (Mallucci P, Branford OA. Plast Reconstr Surg: 2014;134:436–447). This ratio calls for more fullness in the lower poles of the breasts than in the upper poles. Shaped implants are designed with this shape in mind. However, this ratio, 45:55, is also the same as the ratio among women choosing to have a breast lift, who have sagging breasts to start with. (Swanson E. Prospective photographic measurement study of 196 cases of breast augmentation, mastopexy, augmentation/mastopexy, and breast reduction. Plast Reconstr Surg. 2013;131:802e–819e.) After breast augmentation, this ratio is closer to 1.6:1, and these patients report very high levels of satisfaction, 98.1%. Plastic surgeons need to remember that women desire ideal breasts, not necessarily natural-appearing ones (there being nothing more natural-looking that sagging breasts!).

Dr. Eric Swanson-Breast augmentation illustration

These dimensions are actual mean measurements for a group of breast augmentation patients (Swanson E. Prospective photographic measurement study of 196 cases of breast augmentation, mastopexy, augmentation/mastopexy, and breast reduction. Plast Reconstr Surg. 2013;131:802e–819e.).

 

What Is an Appropriate Breast Size?

 

Most women prefer larger breast sizes over smaller sizes. Of course, too much of anything can be detrimental, by definition, and very large breasts are undesirable to most women. The desired breast shape is parabolic in the upper pole, the shape of an umbrella held forward, and semicircular in the lower pole. Loss of fullness in the upper pole and excessive sagging of the lower pole are common complaints and universal ones, regardless of age, race, or culture.

 

Plastic surgeons have, historically, often been conservative in their size recommendations, and many are reluctant to insert large implants (implants > 350 cc).  There is a perception that such sizes increase the complication rate. However, outcome studies of my patients actually show a positive correlation between implant size and patient satisfaction, and no increased risk of complications. Today, my average implant size is just under 400 cc, and women choosing large sizes tend to be highly satisfied.

 

No plastic surgical procedure has received as much public attention, and scrutiny, as breast augmentation. Breast augmentation decreased in popularity in the early 1990s due to media attention regarding the safety of silicone gel implants, and the 1992 FDA decision to make silicone gel implants unavailable to women desiring cosmetic augmentation (but allowed back on the market in the United States in 2006). Breast augmentation has resumed its place as one of the most popular cosmetic procedures today.

 

The procedure is not perfect and there are problems. However, even when complications are encountered, almost all women are still satisfied with their decision to have the procedure and would do it again. Fortunately, provided there is excellent communication and trust between patient and surgeon, almost all complications can be managed successfully. Very few women decide to have their implants removed and not replaced. Some women decide to have their implants removed and a simultaneous breast lift. But even this situation is unusual. Most women of all ages will have replacement implants.

 

It is important for the surgeon to try his or her best to reach an acceptable outcome with implants because the alternative, “deflated” breasts, is unattractive. Excellent communication, trust, skill and patience are needed between patient and surgeon because revisions are not without risk, and several procedures may ultimately be required. Like a marriage, the patient-physician relationship is tested when there are problems.

 

The outcome is different from woman to woman depending on what tissue is there to start with. Human tissues are not like clay and this is the difference between a sculptor and a plastic surgeon. A plastic surgeon has to work within the limits of real materials (the nature of the skin, existing breast tissue, the shape of the chest, implants). Fortunately, there is a range of breast shapes that are aesthetically pleasing. A breast need not be perfect, and perhaps there is some advantage in not having every woman resemble a Barbie doll. Although gross asymmetry is distracting and unappealing, small differences are well-tolerated. Within general guidelines, such as appropriate nipple level on the breast mound, more upper pole fullness than lower, and a tight lower pole, various breast shapes, even slightly pendulous breasts, can be attractive.

 

Breast Augmentation—Usually a One-Way Ticket

 

Furthermore, most changes are one-way. There is simply no “back button” to get you back to where you were before. A breast augmentation creates irreversible changes by stretching the skin and breast tissue. However, the change is so pleasing that few patients would reconsider their decision. In our own survey, 98.7% of women would have the surgery again.

 

Alternatives to Breast Implants

 

Before coming to see the plastic surgeon, some women consider alternatives to surgery. Many women are understandably nervous about having surgery. It is amazing to see advertisements for creams that are supposed to enlarge the breasts, even in the 21st century. Such creams have no scientific basis for effectiveness. A “BRAVA” bra was promoted in the early 2000s as a means to enlarge the breasts about a cup size. Women would have to wear this cumbersome device for 10 hours a day for 10 weeks. The concept was that sustained vacuum pressure to the breasts would enlarge them. It never caught on because of the impracticality of wearing the device and results that were unimpressive.

 

Fat Injection of the Breasts

 

Fat injection is a more feasible alternative to breast implants. Fat injection has been a valuable addition to our armamentarium in facial rejuvenation and body contouring, such as buttock augmentation. It makes sense to consider using our own fat for breast enlargement. Women ask, “doc, can you take it from here and just move it to here?”

 

In the past, the plastic surgery community frowned on fat injection for breast augmentation. However, there is little doubt that it works. The problem is that several treatments may be needed. Only limited increases in volume are possible with a single treatment. It is time-consuming, and there must be sufficient donor fat tissue available, which can be scarce in thin women. Patients after breast augmentation using fat may have calcifications and excessive firmness of their breasts. Women, especially thin women, may have contour irregularities from aggressive liposuction to harvest the fat from other areas.

 

Fat injection cannot duplicate the results of breast implants in restoring upper pole fullness. Implants tend to hold their shape and do not deform with time the way natural breast tissue does (I often tell patients, “The worst thing about breast implants is that they are not the same as breast tissue, and the best thing about breast implants is they are not the same as breast tissue.”) Fat injection of the breasts is likely to be more expensive than a single breast augmentation procedure. Fat injection would be a more popular treatment if the results from breast augmentation using implants were not so consistently satisfactory. I have found fat injection to be a useful technique to fill in small breast defects after lumpectomies or after breast reconstruction, but not for breast augmentation.

 

The Desire for Larger Breasts

 

The desire to have fuller breasts is quite understandable in view of the importance of the breast to a woman’s sense of femininity and attractiveness. To deny this is to deny the reality of female form and sexuality. Fortunately, we live in a time when it is possible to safely enlarge breasts, so that women with small breasts need not be at a social disadvantage. With breast implants an option since the mid-1960s, it is hard to imagine a time when this was not available for women who were under-endowed. We live in a time when the “playing field” can be leveled (or perhaps “unleveled”) so breast-challenged women can compete.

 

Women who come to see the plastic surgeon have done so after considerable reflection. There is an element of embarrassment coming to a plastic surgery office and disrobing. Women are already dealing with some guilt about considering such a self-indulgence. Often, they are thinking about how friends and family are going to react. In the back of the mind are horror stories they’ve read or heard about. It is a wonder they work up the nerve to come in at all! And, yet they do, which shows the strength of the emotional need. In the past, women have endured truly awful treatments, such as silicone injections that led to painful lumps (“granulomas”). This was the only option for women who were born just a decade or two too early or in a country without modern standards of practice.

 

Contrary to popular belief, most women are not having a breast augmentation to satisfy others. Our survey (Swanson E. Prospective outcome study of 225 cases of breast augmentation. Plast Reconstr Surg. 2013;131:1158–1166) found that 89% of women are having the surgery for their own reasons, 11% for both themselves and an “other,” and less than 1% just for the “other.” And, it is not a snap decision—they have usually been thinking of it for years. On average, our patients have considered it for 5 years before having the surgery. Sometimes they have been saving for a long time, or waiting until the kids are off to college and they feel they can reward themselves. I am reassured by consistently hearing women tell me that their husbands are supportive, but in most cases, not pressuring them to do it— “He loves me whether I do it or not. But, if I want to do it, he’s all for it.” Of course, the procedure is such that both partners can enjoy the result. Usually, husbands sit quietly and a little timidly in the examining room. I have never heard a husband object to the concept of larger breasts.

 

What Happens to My Nipple Sensation After Breast Implants?

 

Surveys show that nipple sensation is important sexually to 80% of women. Of course, even if this is not the case, sensate body parts are always to be preferred.  Sometimes I see women in my office who have had breast implants elsewhere who report that their only disappointment was in losing nipple feeling on one or both sides. They are usually still happy with their decision, but would be happier if they kept full nipple sensation! Sometimes nipple sensation does not get the attention it should from plastic surgeons.

 

A major sensory nerve supplies the nipple with feeling. This nerve is called the lateral cutaneous branch of the fourth intercostal nerve, and it comes from the side of the rib cage. It is at risk when the surgeon dissects the pocket for the breast implant.  Some surgeons advocate making this pocket using cautery or a scalpel. Other surgeons, myself included, prefer to make the pocket bluntly, using our fingers. The advantage is that the nerve can often be felt and preserved intact. It might get stretched, but is unlikely to be cut.  A stretched nerve will usually recover, but a cut nerve will not. This approach appears to be successful. Our survey revealed that only 2.3% of women experienced persistent nipple numbness. This rate compares with a range of 12–20% in other series. (Swanson E. Prospective outcome study of 225 cases of breast augmentation. Plast Reconstr Surg. 2013;131:1158–1166)

 

Common Reasons Women Choose Breast Augmentation

 

Of course, like other areas of cosmetic surgery, I see women who are newly single due to a marital breakup or death. They are “back on the market.” Women who are divorced, and whose bodies have suffered the effects of childbirth, want to look as attractive as possible, mainly for their own sense of confidence. They are working out, toning their bodies, and this is just one of the self-improvement items on their list.

 

Some women do not want to have their partner’s attention wandering. One patient told me, “I was at the racetrack with my boyfriend, and there was no denying that full-chested women caught his eye. I just don’t want to have to deal with it.”

 

Breast Appreciation

 

A breast augmentation typically improves a woman’s sense of femininity, which can boost her own feelings of sexuality. Although the priority for most women is an improved body image, almost half report a positive effect on their romantic life. Their breasts are no longer a source of feelings of inadequacy, but a source of feminine pride and enjoyment. One patient told me after her breast augmentation, “This is how a woman is supposed to look.” It is an appreciation she experiences every day, looking in the mirror, putting on clothing, shopping for clothing, wearing an evening gown, and fitting a bathing suit.

 

S.F., Age 29, Pharmaceutical Sales

Height: 5'7"

Weight: 124

Children: 0

Implant Placement: Submuscular

Approach: Inframammary

Implant Size: Right: 480 cc/Left: 450 cc

Implant Style: smooth, round, high-profile, saline

Preop. Bra Size: A/B

Postop. Bra Size: Small D

 

Dr. Eric Swanson patient after photo-breast augmentation

1 year after

 

Testimonial: “I had thought about a breast enlargement ever since my teenage years. I was nervous about it and wondered if I would be too big. As a medical professional, I was concerned about how my colleagues might react. After surgery, I thought I made a mistake. I even called the doctor on a weekend because I was so concerned that my breasts looked too big. But this didn’t last long. Nobody seemed to take much notice at work. The swelling soon went down and I started to get into my new breasts, dressing to accentuate my figure, much the approval of my fiancé. My before pictures don’t even seem like they are of me anymore. I even asked the doctor about going larger. This from a woman who at first was so nervous about being too big!”

 

Women have told me they have developed a new appreciation of their breasts and have a different attitude after breast augmentation. Many are more open and confident about their sexuality. They may wear clothing that they hadn’t considered before. They seem to stand taller and exude more confidence. One of the rewards of being a plastic surgeon is having these women come back and tell me how delighted they are and what a difference it has made.

 

Restoring Breast Volume After Pregnancy and Nursing

 

Many women decide to have their breasts enlarged after losing volume after pregnancy. They enjoyed the enlargement that came with pregnancy and are disappointed to lose it. Many women find their breast size after having children is less than what they had to start with. Ironically, after bearing children, and often breast-feeding, the dubious reward for these maternal duties is shrunken breasts, and, as if that were not enough, a stretched out tummy! I often ask a patient if she liked her breasts more during pregnancy. If the answer is yes (and I don’t remember it ever being no), this is a good indication that she is going to be pleased with an augmentation.

 

J.B., Age 33, Airline Clerk

Height: 5'4"

Weight: 112

Children: 2

Implant Placement: Submuscular

Approach: Inframammary

Implant Size: 300 cc

Implant Style: Mentor textured, round, moderate profile, saline

Preop. Bra Size: A

Postop. Bra Size: C

 

Comments: This 33-year-old had two children. The youngest was 18 months old. She had breastfed for 6 months and noticed a loss in volume. She was comfortable with her breast size before pregnancy and wished to have her breasts restored to their prepregnancy state.

 

Dr. Eric Swanson patient before and after photo-breast augmentation

Before, 7 weeks after

 

High Patient Satisfaction

 

Partly by the process of financial selection, women tend to be in their 20s by the time they arrive in the plastic surgery office. These young women are generally not in a high income category. They are making a sacrifice to have this surgery. It is a sacrifice not to be taken lightly by the surgeon. For many young women, the first question is: “How much does it cost?” A few hundred dollars makes a difference.

 

I often ask patients after surgery “Are you glad you did it?” Of course, they are being put on the spot by their plastic surgeon, but I can tell from their spontaneity and enthusiasm and lack of hesitation in their response that they feel it was worth it. The psychological benefit they will enjoy every day and for years to come compares favorably to discretionary income spent elsewhere.

 

Older Women

 

Women over 50 sometimes ask if they’re too old for a breast augmentation. Of course, there is no real age limit and the results of breast augmentation are appreciated by patients of all ages. In fact, our capabilities of breast rejuvenation, which may include a breast lift in patients with sagging, compare favorably to results from other body contouring surgery, where we often have to settle for skin laxity and cellulite that cannot be completely corrected using presently available techniques. We may as well take advantage of superior results where we can get them! Youthful looking breasts can help compensate for aging elsewhere.

 

Breast Asymmetry

 

About half of women who present for breast augmentation have breasts that are asymmetrical in size and about half have nipples that are at different levels. Including asymmetry in the shape of the chest, nipple/areola size, and level of the crease under the breast, 88% of women have asymmetrical breasts before surgery! Women are often unaware how common this is. We have all seen women’s breasts portrayed in the visual media in various poses and amount of cover. But, most of us are not in the habit of critically inspecting large numbers of naked, unretouched women’s breasts. And, I am at a loss to think of anybody who is in such a habit, apart from a medical doctor or mammographer!

 

As part of the examination, plastic surgeons look for asymmetry before surgery. One reason we do this is to bring any existing asymmetry to the patient’s attention. She may have never noticed it before. But, she will look more closely at her breasts after surgery and, unless she knows about it beforehand, she may notice for the first time that one nipple is slightly lower or higher, or points outward more, than the other.

 

Nipples naturally point slightly outward because of the curved contour of the chest. A breast augmentation will not change this. It will not alter nipple placement on the skin. Sometimes, an optical illusion is created after surgery by the low position of the nipple on the breast mound—it appears that the implant is too high, when in fact the implant is correctly positioned on the chest, but the nipple is too low. Patients wonder, “Can’t you just put the implant lower?” But to lower the implant in such a situation, would make the whole breast appear too low. It would sit lower on the chest, look unnatural and would displace the natural crease under the breast (“inframammary fold”) downward. The implant has to be in the right position for the breast, not for the nipple. The logical way to correct a lowered nipple position is to elevate the nipple with the saggy lower breast tissue, and a breast lift is the operation that does this (See Sections on Breast Lift and Breast Lift with Implants).

 

Women cannot expect breast implants alone to significantly raise the nipple position. Implants do not take up enough of the slack to really elevate the nipple. Our measurement study showed that the nipple is elevated only a few millimeters on average after a breast augmentation with implants (Swanson E. Prospective photographic measurement study of 196 cases of breast augmentation, mastopexy, augmentation/mastopexy, and breast reduction. Plast Reconstr Surg. 2013;131:802e–819e.). Women who have low-set nipples are best served with a breast lift at the same time.

 

Reducing Size Asymmetry by Adjusting Implant Volumes

 

The final breast volume represents a combination of the breast tissue that is there to start with plus the implant, which explains why two women with the same size implants may have different breast sizes. The implant simply fills out the breast envelope, so that characteristics of the breast (amount of existing breast tissue, nipple size and position) remain unchanged. With saline-filled implants, size asymmetry may be reduced by simply adding more fluid, or using a slightly larger implant, or both, on the smaller side. The prevalence of existing volume asymmetry explains why the implant volumes are often not identical in the patients shown in this section. Of course, any small size discrepancy is minimized anyway as the volume of both breasts is increased by the presence of the implants.

 

Silicone gel implants come already prefilled, so that very minor size adjustments are not possible. However, in patients who have noticeable size asymmetry, two different sized implants are used.

 

Perfect symmetry is virtually impossible and, fortunately, unnecessary to get an ideal resultone that is very pleasing to both the patient and her surgeon.

 

In patients with greater degrees of asymmetry, the breast “envelope” is tighter on the smaller breast and looser on the larger one. The nipple on the larger breast is lower and the areola is usually larger, because the nipple and areola are part of the same expanded ectodermal appendage that forms the breast. We need to use a larger implant on the smaller side to reduce the size discrepancy. Ideally, we would like to take up the slack more on the larger side, which tends to be saggier, but we have to use a smaller implant on the larger side (so this side does not end up too big), so the nipple will remain lower on the larger side. In this situation, a simultaneous breast lift is the better option. This way, the breast envelope can be tightened as necessary. The nipples can be more symmetrically placed at the same level and the areolae can be reduced to provide a better match.

 

In most cases, however, a mild degree of asymmetry does not bother women enough to have the additional scars that come with a breast lift. It is unusual for me to perform a breast lift on just one side. Usually, it is better to do it on both breasts. The breasts and nipples appear more symmetrical this way, because a lifted nipple looks different from a natural one. The border of the areola, which has been incised with a scalpel, is more distinct than a natural areolar border. It does not fade away into the surrounding skin like a natural areola. Better to have matching areolae. Additionally, many women, whose nipple is low enough on one side to justify a breast lift, benefit from having both breasts lifted anyway because even the smaller breast is a little saggy.

 

S.S., Age 38, Architect

Height: 5'3½ "

Weight: 101

Children: 1

Implant Placement: Submuscular

Approach: Inframammary

Implant Size: 280 cc

Implant Style: Mentor smooth, round, moderate profile, saline

Preop. Bra Size: A

Postop. Bra Size: C

 

Comments: This patient said she was a D-cup size when she was pregnant. Her breasts shrank considerably afterward and she’d considered having implants for years. She has existing asymmetry of the nipples, with the right nipple lower than the left. This is quite common. Breast implant surgery does not change the position of the nipple relative to the breast, but if the level is not too dissimilar, there is usually no need.

 

Dr. Eric Swanson patient before and after photo-breast augmentation

Before, 5 months after

 

B.S., Age 20, Administrator

Height: 5'8"

Weight: 126

Children: 0

Implant Placement: Submuscular

Approach: Inframammary

Implant size: Right: 370 cc/Left: 425 cc

Implant Style: Mentor smooth, round, moderate profile, saline

Preop. Bra Size: A

Postop. Bra Size: Small D

 

Comments: This 20-year-old was single and had no children. She desired a D-cup size. Her right breast was noticeably larger than her left. The nipple and areola were also larger on this side. Her skin was youthful and tight, having never been stretched by pregnancy. After surgery, the symmetry is improved, although, as expected, the left nipple is still higher than the right. A small D-cup size was achieved.

 

Dr. Eric Swanson patient before and after photo-breast augmentation

Before, 1 month after

 

Sagging Breasts (Ptosis)

 

You might think that breast implants would help take up the slack of the breast and correct sagging. The nipples would rise back up as the breast volume is restored. However, measurements show that the nipple level does not change significantly after breast augmentation. (Swanson E. Prospective photographic measurement study of 196 cases of breast augmentation, mastopexy, augmentation/mastopexy, and breast reduction. Plast Reconstr Surg. 2013;131:802e–819e.). Although implants help fill out the upper poles, they are of limited benefit for the lower poles, where the extra breast tissue persists. Because of this limitation, breast implants alone will not overcome sagging. Many women accept this and are not overly concerned about it. They may say: “Well, I’m not trying to look like I’m 18 anyway. But I would like to look good in clothing.” Or, “I can wear a bra for that.” For other patients, who do place importance on perky breasts, correction of sagging is a priority and we proceed to discuss the breast lift procedure (See Sections on Breast Lift and Breast Lift with Implants).

 

W.B., Age 30, Account Executive

Height: 5'4"

Weight: 114.5

Children: 3

Implant Placement: Submuscular

Approach: Inframammary

Implant Size: Right: 475 cc/Left: 480 cc

Implant Style: Mentor smooth, round, moderate profile, saline

Preop. Bra Size: B

Postop. Bra Size: D

 

Comments: This woman’s breasts were stretched out from three pregnancies. She wished to be augmented to a D-cup size. Like the previous patients, she did not want to have a breast lift because of the scarring. Although the implants have taken up some of the slack, lower pole sagging persists, apparent on the lateral view. Some patients accept this sagging; many do not, and elect to have a breast lift simultaneously.

 

Dr. Eric Swanson patient after photo-breast augmentation

Dr. Eric Swanson patient before and after photo-breast augmentation

Before, 10 months after

 

N.B., Age 32, Registered Nurse

Height: 5'4"

Weight: 152

Children: 2

Implant Placement: Submuscular

Approach: Inframammary

Implant Size: Right: 470 cc/Left: 480 cc

Implant Style: Mentor smooth, round, moderate-plus profile, saline

Preop. Bra Size: C

Postop. Bra Size: Full D

 

Comments: This patient wished to be augmented to a D-cup size. She was aware that her breast sagging could only be corrected with a breast lift. However, she was concerned about the extra scarring of a breast lift and thought that she could return for a lift later, when she was older, telling me, “I’m 32 and single.” Although nipple elevation is usually negligible after breast augmentation alone, in her case the nipples came up 3 cm and she was happy with her decision. This case demonstrates the maximum nipple elevation that can be achieved with implants. This degree of nipple elevation was only possible because larger implants were used. Fortunately, she wanted a large size anyway.

 

Dr. Eric Swanson patient before and after photo-breast augmentation

Before, 3 months after

 

Breast Sagging—Asian

 

T.H., Age 33

Height: 5'1"

Weight: 125

Children: 2

Implant Placement: Submuscular

Approach: Inframammary

Implant Size: Right: 340 cc/Left: 360 cc

Implant Style: Mentor smooth, round, moderate profile, saline

Preop. Bra Size: B

Postop. Bra Size: Full C

 

Comments: This patient’s right breast was slightly larger and saggier. Therefore, additional saline was injected on the left side. Such fine-tuning of implant volume does not correct nipple asymmetry (a breast lift would be needed to do this), but in most patients, a small degree of asymmetry in nipple position is acceptable.

 

Dr. Eric Swanson patient before and after photo-breast augmentation

Before, 6 weeks after

 

What Happens to the Areola Size After Breast Implants?

 

Measurements show that the areola stretches about 1 cm after breast implants are inserted. Women do not favor very large areolae. Our survey showed that once the diameter exceeds about 5 cm, women find them too large (Swanson E. Prospective photographic measurement study of 196 cases of breast augmentation, mastopexy, augmentation/mastopexy, and breast reduction. Plast Reconstr Surg. 2013;131:802e–819e). So if a patient has large areolae already, she may consider an areola reduction procedure at the time of her implants. The same incision can be used to insert the implants, avoiding two incisions on the breast. Commonly women with large areolae also have some extra slack in their breasts and will choose to have a breast lift with their implants, accomplishing both tasks simultaneously— correcting breast sagging and reducing areola size. Areola reduction may be a deciding factor for women with lesser degrees of breast ptosis who may be considering whether to have a mastopexy at the time of breast augmentation. (Swanson E. Prospective outcome study of 106 cases of vertical mastopexy, augmentation/mastopexy, and breast reduction. J Plast Reconstr Aesthet Surg. 2013;66:937–94).

 

 

 

 

 

 

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Dr. Eric Swanson-Breast augmentation illustration

Dr. Eric Swanson patient after photo-breast augmentation

Dr. Eric Swanson patient before and after photo-breast augmentation

Dr. Eric Swanson patient before and after photo-breast augmentation

Dr. Eric Swanson patient before and after photo-breast augmentation

Dr. Eric Swanson patient after photo-breast augmentation

Dr. Eric Swanson patient before and after photo-breast augmentation

Dr. Eric Swanson patient before and after photo-breast augmentation

Dr. Eric Swanson patient before and after photo-breast augmentation