Q: Dr. Eppley, I am very excited about my upcoming breast augmentation procedure. I am sending you some photos of the breasts in which I DO like and some in which I DONT~ let me know your thoughts when you get the chance. I want a round high full look but I don’t want the implants to go too far to the sides and I don’t ant a big gap between my breasts.
A: As I mentioned during our consult and as a general breast augmentation comment, breast implants mainly accentuate or magnify the exiting anatomy (positive or negative) of one’s natural breasts. The most perfect breast augmentation results typically occur in those women who have good breast anatomy to work with, albeit smaller than they want. (good breast skin with the existing mounds high up on the chest, spaced close together and with the nipples centered on the mounds pointed straight forward) You have three ‘negatives’ that must be understood/managed in trying to reach the best result possible, moderate breast sagging, low and outwardly pointing nipples and widely spaced breast mounds.
The spacing between the breast mounds and a high very round upper pole look is purely related to volume and projection of the implant. While we had discussed 375cc high projection silicone gel implants, your desired pictures suggest that more volume than that would be needed to expand the mound properly. If all we do is use implant volume to mainly expand the upper and inner poles, the nipple position will be driven further down which will not be completely negated by the nipple lifts. Therefore I think a slightly higeher volume like 435cc will be needed. Also although the nipple lifts will help, they will not end up perfectly centered on the mounds without a vertical breast lift…which I would not do in you for scar concerns. Any persistent or undesired low nipple position can be managed by a secondary additional nipplel ift down the road if desired when the tissues have relaxed and more upward movement may again be possible.
Dr. Barry Eppley