Breast Augmentation

Procedures by Dr. Bosshardt

Roll mouse over picture to see postoperative procedure results

Front

Side

This 29 year old patient desired fuller, larger breast. and was a padded B cup bra. 6 months after implants of 400cc she wears either a 36 C or 34 D cup bra. The breasts are soft and feel entirely natural. This is an exceptional result, the kind surgeons love to show off. Although nearly all results are going to range from good to excellent, once in a while we get a nearly perfect result, as in this case.

The picture on the right is an angled view of the same patient.

This young lady described her breasts as �fried eggs� after two children. She desired larger breasts with more superior fullness. The final implant size was 375 cc. After, she was a D cup

25 year old patient desiring breast augmentation. She wears a �small B� cup bra. She is 5 feet 8 inches tall and weighs 141 pounds. The left breast was a bit smaller than the right.  Implant size: right 450 cc, left 500 cc. Postoperative bra size is a 34D cup.

49 year old patient was an �A� cup. 6 months after augmentation with 380 cc Mentor round, smooth, saline implants placed under the pectoralis muscle. Bra size is now a �C� cup.
 

23 year old patient was an "padded B" cup.  She felt self conscious about wearing bathing suits and not filling her clothes out. 6 months after augmentation with 380 cc on the right and 360 on the left to compensate for a slight asymmetry. Post operative bra size is a 36 D.

21 year old patient was a 34 C cup before her one pregnancy but after that pregnancy, and breast feeding, she dropped to a 34 B cup. She liked her D cup size while she was breast feeding.
After augmentation with 350 cc. She now wears a 34 C/D cup bra. 

38 year old patient was a 34 B that had lost volume in her breasts after her pregnancies and losing over 20 pounds. At 6 months after saline implants of 475 cc, placed above the muscle her Bra size is now a D cup.

24 year old patient was a 32B and felt she was too small and did not fit well into her clothes or bathing suits. This was a 25th birthday present to herself. 6 months after implants of 350cc she now wears a 34 C cup bra.

Front

Side

The picture on the right is seen on an angled view to better show the degree of sagging. As long as the nipples are above the lower crease of the breast, augmentation is a good option to fill them out.

35 year old patient experienced loss of volume in her breasts after her pregnancies and was a 34 B cup bra. 6 months after augmentation with McGhan anatomically shaped, texture saline implants in pockets above the muscle. She has experienced contraction of the implant pocket, called capsular contracture. This causes the breasts to feel very firm and alters the shape of the breasts. In her case, the breasts area much too round and the implants have shifted apart producing too wide a space between the breasts. This required surgery to correct. Capsular contracture requiring surgical correction occurs in less than 5% of breast augmentations.

The picture on the right is 3 months after revision. Her old implants were removed, the contracted capsule was released and new implants inserted. These are Mentor round, smooth saline 380 cc implants. The difference in the appearance of her breasts is obvious and they are very soft.

Pre-Operation- Patient is in her 60�s and desired breast augmentation. Her history was interesting in that she had undergone treatment for cancer of the left breast with a lumpectomy and radiation therapy. This was a concern because of the scarring and fibrous reaction in irradiated breasts that might prevent them from staying soft with implants. Below are the Post-Operation results.

She is seen 6 months after augmentation with Mentor smooth, round, high profile saline implants placed under the muscle. Both are 310 cc. the left was filled to 340 cc and the right to 310 cc to compensate for a size difference in her breasts. The right side was perfect; very soft and natural. The left side was slightly firmer and more �round�. Given her history, this was felt to be acceptable. She was thrilled.

She came in 2.5 years after augmentation. She remained very happy with her implants and has had no problems. She has gained 22 lb. which is more apparent in the right breast. This is also due to the radiation scarring in the left. The left breast has actually softened with time and both looks and feels more natural now.  

In the after photos, she has had the implants removed and the scar tissue has been released in a procedure called a capsulotomy. Her new implants are Mentor round, smooth, moderate profile implants with a volume of 475 cc. She is shown 6 months after surgery with very soft, natural feeling breasts. Bra size has gone from a small C cup to a full C/D cup.

This patient presents several interesting issues. Textured implants were designed to counteract the tendency in some patients for contracture of the capsules around the implants, producing the distortion and firmess she demonstrated. In my experience, I have not seen these implants to be effective in accomplishing this. Textured implants are more prone to show visible rippling and to leak than smooth saline implants. This patients also heals with thickened, very pink reactive scars, called hypertrophic scars. These can take a year or more to settle down. Scar massage and the use of silicone gel ointment can speed up the process of softening and flattening. I also offered her free treatment with our non-ablative fractional laser but this was declined.