options

Q: Breast Explantation Due to Intracapsular Rupture with Fluid Build

Submitted by Q-A from clee on Sat, 05/14/2011 - 09:07

fluid build up in my right breast, ultrasound showed there is a thick film of capsular around my implant. Look swollen but no pain. I went to 2 surgeons, one said to remove implant without removing any capsules nor stitch up the implant pocket. While the other one will remove all capsules, stitch up pocket.

My implants are under the skin and they're saline. I have them for 7 yrs. Which one should i go with? Will the fluid goes away so i can leave them in since I have no pain? Please advise.Thx

A: Not really understanding some points...your clarification necessary

You mentioned that you have saline implants for 7 years, yet they are ruptured with fluid and swelling. Saline ruptures lead to deflation and their treatment is by replacement usually with assistance of the manufacturer provided the parameter of the warranty are followed.

Silicone is a different matter. 7 years ago there was a moratorium on their placement. Ruptures silicones should probably be removed.

If you are having exchange of implant, then either a pocket exchange or capsulectomy would be wise since the capsules are thick according to your imaging studies.

Q: Breast Augmentation Recommendations for Appropriate Size & Profile

Submitted by Q-A from clee on Fri, 05/13/2011 - 12:57

Scheduled for a BA - April 28,2011. My PS recommends a Mentor,smooth,300cc HP or 275 cc Mod+. I feel this is smaller for my body type than I was expecting(from my research in what I have seen from other ladies of my stature averaging 350-375cc's).

I am 5'8 1/2" tall, 130lbs, 30" ribcage, 34 AA, 16 cm sternum to aerola, 18cm sternum to nipple, 5cm nipple to breast crease, BWD - 11.7cm. Looking for opinions on an appropriate size as hoping for a bit bigger (~375cc max). Is this possible for me?

A: Breast width dimension is a good guide

Your BWD of 11.7cm has you as a suitable candidate for multiple sizes and projections from base width to 11.5 to 12.5. I would suggest your review with your surgeon the various size and projection options with those base widths to come to an implant with your goals in mind.

Q: Best Procedure to Fix Ptosis and Tubular Breasts?

Submitted by Q-A from clee on Fri, 05/13/2011 - 11:55

My breasts were always very tubular and oddly shaped. I dealt with weight gain and loss throughout high school (Bs to DDs). I want pre-consultation insight from a few doctors or patients that are familiar with the different types of surgeries available, mainly the ones best suited.

How hard is it to fix my ptosis, skin sagging, over large nipples and tubular breasts? $ is not an option when it comes to my body. What ways can I combat scarring being that I'm bi-racial? I am 5'10 145 lbs 20y/o

A: You have a mild form of tubular breasts

You a mild tubular breast form with what appears on your photo to be a good tissue envelope. Lowering your inframammary fold through a periareolar approach with circumareolar mastopexy and areolar reduction is a good plan.

Furthermore, placement of a submammary cohesive gel implant will likely yeild better shape with less chance of the waterfall or late double bubble look from descent of the breast. You should use silicone scar sheeting on the surface of your healing incisions to lower the risk of a poor scar outcome.

Q: Hardness Around the Incision Site 4 Years Post Breast Augmentation - What Can I do About it?

Submitted by Q-A from clee on Fri, 05/13/2011 - 11:38

A: Many reasons for this but do require at least photo

There are many potential reasons for this.  While not exhaustive, a short list of possible causes includes keloid scar, inclusion cyst, ectopic breast or fat. More precise comments as to your situation might be possible if you are able to upload a photo. Even better would be a visit with your plastic surgeon.

Q: Is Flash Recovery Breast Augmentation an Option Going from A to D Cup?

Submitted by Q-A from clee on Fri, 05/13/2011 - 11:09

A: This is pure marketing

The energy and discussion created by FLASH is remarkable. When distilled to its core, it is a collection of techniques routinely employed by good surgeons worldwide. Regarding change from A to D up sizing, the risk of pain and risks are elevated. A less ambitious size enlargement would lower the risks and increase the likelihood of a satisfactory outcome.

Q: Tubular Breasts, Lift and Augmentation Options

Submitted by Q-A from clee on Fri, 05/13/2011 - 08:10

Dear experts, I would like to know what type of operation methods you would pick for this type of breast. I assume these are tubular as there is a wide gap between, the areola is that huge and as there is only little space between the areola and the crease of the breast.

Is it possible to breastfeed with such breasts in the first place and if yes will it be possible after an operation? Also, can implants be placed so that it doesnt show, even with so little own tissue? Thank you very much!

A: Breast feeding is possible now but might be affected after surgery

Using your photos a good surgical plan might include the following:

  1. Lowering your inframammary fold
  2. Areolar reduction with periareolar incisional access for implant placement
  3. Releasing the breast tissue so that it spreads and redistrubutes evenly around the implant
  4. Submammary placement of the implant

Right now your ability to breast feed should not be affected however after surgery listed above you might not be able to as the release of breast tissues may disrupt the breast ducts.

Q: Which Size Implants Would Look Better: 5'6" and 133lbs

Submitted by Q-A from clee on Fri, 05/13/2011 - 08:02

I am 5'6" and weigh 133 lbs. I am having a silicone breast augmentation next month, but I'm still confused as to which size to go with. I'm debating between 371cc and 397cc. I don't want to appear too large, but I also don't want to regret not going large enough. Any suggestions?

A: Your breast dimensions should drive your choice of implant

Your present breast dimension should drive your choice of specific implant. Measurements of your breast base will determine the implant footprint. Using this footprint as your starting point you can then choose the projection based on the manufacturer. Major manufactures have create designs based on measured desirable norms in the population. They market them using different terminology such as mod, mod plus, high profile. What is important is the actual measured projection and base footprint match to your breast.

Q: Are my Breasts Considered Abnormal and Tubular?

Submitted by Q-A from clee on Fri, 05/13/2011 - 06:11

My breasts are very small and set far apart, with large areola's that almost point to my sides. I have had 2 miscarriages and since then, I have noticed a greater loss in breast mass / tissue at the upper portion of my breasts. They have always looked disfigured to me and I am very self conscious because of this. So, is this a normal condition? Or tubular? What can be done to repair the abnormality? Thank you.

A: Tubular breasts are characterized by having a constricted breast base.

Tubular breasts are characterized by having a constricted breast base with resulting breast ptosis and widened areola from upward displacement of the the breast tissue under the nipple.  All the tissues are normal.  However most plastic surgeons pay much attention to this breast form as the best corrective treatments require thought and adjustments in our breast augmentation techniques to have the best outcomes.

Specific to your case, breast tissues are normal but the form is indeed tubular but not severe.  In planning your treatment there would need be a plan to address the following: 1) constricted base to your breast, 2) psuedoptosis of the breast, 3) volume enhancement, 4) areola reduction, 5) lateral positioning of your nipple areola complex.

Points 1-4 can be simply addressed in your case with lowering of your inframammary crease and release of breast tissue to expand the breast base, submammary placement of a implant to correct volume, and areolar reduction.  However point #5 remains a problem as its treatment is less predictable.  A thorough discussion of the risk benefits of a surgical plan for your lateralized NAC should be had with your plastic surgeon as the resulting scars for treatment of laterlized NAC may not be the best return for your energies.  Best of luck to you.  

Q: How many cc's will give me a natural and proportionate look?

Submitted by Q-A from clee on Thu, 05/12/2011 - 09:51

I am 5'7", 200lbs with large body frame, wide shoulders/chest, small 40B-cup; I look manly. I am scheduled for a BA w/silicon in two weeks, but I am still stuck as to which CC size/profile shape will look best on me: 500cc or 550cc, moderate or moderate plus. I want to look natural/proportionate and do not want to regret 'not going bigger' later, but neither do I want to look like an 'overdone' porn star; I told the dr he can choose the final size/profile for me, but I'm still confused. Please help!

A: Use implant dimensions to guide you for the desired look

Thank you for the photos. Your final look will be determined by how the implant projects from your chest base and the tissue envelope that it sits under.  cc volume is not the ideal means by which to judge the fit of an implant.  Most mass manufactures of implants have modeled their styles of implants offered to match the base width of your native breast/chest.  As general rule, the measured base diameter of your chest/breast will yield the size of the implant footprint.  The projection is then adjusted by selecting from the mass production list of all major breast implant companies.  This is the most reliable standard to yield natural looking breast outcomes following breast augmentation. 

Instead of focusing on cc volumes, select the dimensions of the implant to match well with the base of your breast augmentation will have a far greater chance of being a natural look.  Wishing you a safe and satisfying experience.

Q: 600cc silicone implants look small on me

Submitted by Q-A from clee on Thu, 05/12/2011 - 03:13

My first ba I had 340cc overs mod profile and was unhappy as they looked too small. I had my 2nd ba 3 months ago and went for 600cc HP silicone under the muscle. I was really gutted to find I still haven't got the desired projection I was after. My surgeon said it's because I have a high rib cage which is why my implants do not project much. Should I consider a ultra high profile saline implant or just accept the fact boobs don't look big on me??? Please help!!! Thanks

A: Sizing an implant to achieve a desired shape and projection can be a challenge

Sizing an implant to achieve a desired shape and projection can be a challenge. The final projection and shape achieved depends on the following: 1) the underlying chest wall supporting the implant. A flat foundation will allow the implant to fully express its projection whereas a tilt to the chest wall will result in loss of or uneven projection to one side. 2) from the underlying shape of the implant. The actual measured dimensions of your implant to the dimensions of your breast envelope is more important than the brand model marketed. 3) the tissue plane of implantation and its resistance to stretch is another major factor on both projection and the visibility of the implant margins. As surgeons, we can only control the selection of the implant model and the tissue plane of insertion. Perhaps you should have another visit (with your surgeon or another experienced opinion) to review the various suitable dimensions of implants to be tried via sizers in the operating room to better approach your goals. Furthermore, submammary placement is more likely to achieve the full implant projection then submuscular placement, however, the implant (especially saline implants) will show ripples and edges in this submammary plane.