Choosing size and profile of Mentor, round, smooth silicone implants for tuberous breasts? (photo)
Doctor Answers 7
400 cc HP Round Silicone Implant under the Muscle through IMF
The IMF incision can be used to place the silicone implant under the muscle. You do not have areolar herniation, you just need the inferior pole released. This can be done through the IMF incision.
What size for tuberous breasts?
You have a dilemma here. With the kind of breasts you have, surgery will impact your ability to breast feed and could also result in loss of sensation. If you're desiring to breast feed as best you can, wait until your have your children then have your surgery. Regardless, implants can be placed under the muscle (dual plane technique). The areola incision is preferred since it makes it easier to release any constricting bands across the lower pole and fold and allows for a areola reduction should you decide to have one. Personally, I would go for a size that you will be happy with since there will always be some stigma of the tuberous breast.
Breast implnt size
The implant size is best determined by starting with the diameter of your breast. Then a higher projection , combined with release of the inferior pole, and under the muscle, should provide a very nice result.
Talmage Raine MD FACS
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First, you can place the implants under the muscle. Second you possibly will need scoring of the lower pole to expand it. Yes, it may impact breast feeding.
We actually need to make certain measurements on your frame to select the most proportional implant - so it's difficult to give you specifics in this forum. I notice you have a relatively short distance from your nipple to your crease underneath the breast- and this is likely to be the limiting factor for your implant size, as the radius of the implant needs to fit that distance.
As for tuberous breast correction, you most certain can get a nice correction with a dual-plane technique. Subglandular placement is not a requirement, in my experience.
Your next step is an in-person evaluation with your friendly, neighborhood PS.
It doesn't look like you really have tuberous breasts to me, but you don't have much skin from the bottom of your areola to the inframammary crease. If you don't do some sort of small lifting procedure the nipples would still look pretty low afterwards. Under the muscle is fine even with people with tuberous breasts. It's a matter of knowing the proper technique to allow the implant to fill out the breast tissue even when it's under the muscle. But again it doesn't really appear like you have tuberous breasts to me.
Breast Implant Position and Size for Tuberous Breast?
Thank you for your question and photos.
Although I cannot provide you with precise advice without direct examination and a full communication of your goals, generally speaking I would recommend that breast implants be placed in the sub muscular (dual plane) position if at all possible.
This positioning allows for more complete coverage of the breast implants leading to generally more natural feel/look of the implants in the long-term. This position will also decrease the potential for rippling and/or palpability of the implants (which may increase with time, weight loss, and/or post-pregnancy changes).
The submuscular positioning also tends to interfere with mammography less so than in the sub glandular position. The incidence of breast implant encapsulation (capsular contraction) is also decreased with implants placed in the sub muscular position.
On the other hand, the sub muscular (dual plane) breast implant positioning does have the potential downside of “animation deformity” ( movement/ distortion of the breast implants seen with flexion of the pectoralis major muscle). Again, I think the advantages of sub muscular (dual plane) breast implant placement far outweigh the potential disadvantages associated with breast implants placements of glandular position.
In regards to the best breast implant size/profile to achieve your goals, the best online advice I can give to is:
1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you're looking for. Ask to see lots of examples of his/her work.
2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “most natural look” or “C cup” etc means different things to different people and therefore prove unhelpful. Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate.
3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery.
I hope this ( and the attached link) helps.