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Q: Small Anatomical Implants for Tuberous Breasts?

Submitted by Q-A from clee on Fri, 05/13/2011 - 07:36

I'm having breast augmentation surgery to correct my small (symmetrical) tuberous breasts. I do not want much upper pole fullness or projection. I want my breasts to stay quite small and have a very natural slope. My doc (who specializes in breast reconstruction) has ordered Mentor 220cc silicone gel anatomical implants. He says they will not rotate if the pocket is the right size. Many docs on this site seem skeptical about anatomicals/textured. Are these implants right for my condition?

A: Your specific measurements and body type should drive implant choice

Your specific breast measurements and body type should drive implant choice.  Both the anatomic and round could work well but its actual selection must be driven by the details of your breast measurements.

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: 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.