Patient - Breast Augmentation

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This very athletic lady presented seeking breast augmentation. She has had two children and states she lost some volume after that but was never very large to begin with. Her bra size is a 32-34 A cup. She presented some challenges in that she is quite thin and muscular, has little body fat, very tight skin, and very small breasts with a wide space between them. Not surprising, she works out very hard in the gym regularly. 

Breast Augmentation - Dr. Richard Bosshardt
Breast Augmentation - Dr. Richard Bosshardt


I performed her augmentation with Allergan Natrelle Inspira Style SRM round, smooth gel implants. They are 310 cc, a conservative size but, given her very tight skin and small breasts, I was happy to get these in. I felt that she would do well with gel implants because her new breasts will be almost all implant and gels tend to show less visible or palpable rippling. These are under the muscle and I released the muscle in a dual plane fashion so that she does not have much traction on the skin when she contracts her pectoralis muscle. She has resumed her gym workouts with no problems or noticeable loss of strength. She has normal sensitivity in her breasts. They are very soft with some palpable, but no visible, ripples. Although the photos make the right side look larger, in person she is very symmetrical. The longer inframammary scar is a trade-off of having gel implants. She has not sized herself to new bras but I would guess her to be a full B/small C cup. She is very happy and so am I. 

PS- some might ask why I did not use the new, anatomically contoured, form-stable (gummy bear) implants in this patient since she is actually a great candidate for those. I have several reasons. The gummy bear implants are much more expensive, require a longer incision than regular gel implants, and some patients do not like the firmer feel of the breasts. In addition, all anatomic implants are textured and these are the implants than have been connected to breast implant associated lymphoma. Although this is rare, I think the verdict is still out on textured implants and so am not using these in my practice at this time. Smooth implants have never been implicated in this condition. 

Breast Augmentation - Dr. Richard Bosshardt
Breast Augmentation - Dr. Richard Bosshardt

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