breast tissue

Q: Saline or Silicone for Someone with Adequate Breast Tissue?

Submitted by Q-A from clee on Fri, 05/13/2011 - 12:07

Getting BA done next month. My doctor usually recommends silicone because most of his patients have an A cup. After my exam, he said I could go with silicone or saline because I'm a full 34B cup. He said I have enough breast tissue so there wouldnt be a difference, and would get the same results.

It will be soft as silicone, and give me good projection. I'm a 34 full B, shooting for a 34 full D.What would you suggest? Also, 450cc or 500cc?Would like fuller, natural feel, look, and movement.

A: You have choices, let your preferred incision guide your implant decision

Let your incision choice and size of implant dictate your type of implant. If you prefer to scar in the areolar complex, then use a saline implant as your areola is not large enough to permit placement of a large silicone implant. If you prefer the inframammary incision, then go with the cohesive get as the feel more natural. Request for them to be place in the submammary position as it is far less painful and you have sufficient breast to adequately prevent ripples even from saline implant to show.

Q: Breasts Don't Look Right After Augmentation

Submitted by Q-A from clee on Fri, 05/13/2011 - 10:22

I had PS breast augumentation and lift in July 2010 with basically same results as pictured. Flew to PS in January 2011 b/c he said implants needed to be "dropped" in place. He opened me up, found tissues around nerves- oh! so, the intense pain I'd had WAS real, and also ended up re-doing the lift.

Now,PS sees results of recent (March 2011) photographs, and says I just need to come in and have the implants dropped! I think it's more complicated. SOMETHING IS NOT RIGHT!

A: Your subpectoral placement of implants has made the condition worse

A revision of the mastopexy alone will not be sufficient. At best it will temporarily help until this soon returns. More predictable in outcome wound be to exchange the implant into a submammary plane along with a redo of the mastopexy. This would be best managed with a silicone cohesive implant.

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: 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.