Breast Augmentation Procedures
I have been in practice in Denver for 29 years and have a great deal of experience with breast augmentations. I have been recognized as one of Denver’s “top docs” in 5280 Magazine from 1994 to 2006, particularly for breast augmentations. I went to Yale for college, Stanford for medical school and Georgetown and Duke for my eight years of postgraduate surgery training. I am certified by the American Board of Plastic Surgery. While I am past-chair of Plastic Surgery at Saint Joseph’s Hospital, I now go to Rose Hospital, Presbyterian/St. Lukes Hospital and Midtown Surgery Center, all in Denver.
I use a variety of different incisions for breast surgeries–under the bra line, around the nipple and in the arm pit, depending on the patient’s preference and the shape of their breasts. A lot of doctors only use one incision. I use a variety of implants: mostly salt water filled, but also the approved gels, in various sizes and shapes (round, oval, tear-dropped, etc), depending on what is needed. The surgery is done with the patient asleep under general anesthesia with another doctor, who is a board-certified anesthesiologist. It takes about 2 hours. Most people go home after the surgery, but arrangements can be made to spend the night in the hospital if you prefer. When you wake up all the stitches are on the inside, so there are no stitches to remove later. I place special water-proof tape on the outside of the breasts to hold the implants in proper position for the first week or so. You are in an ace wrap for about 48 hours, but after that you can shower, and wear just a regular jog bra. Most people are very sore for the first few days, but are able to return to work after one week, assuming they just have a desk job. For people who have more physical work–such as nurses, airline attendants, etc.–more time off work may be required.
Sometimes it’s best if you just come into the office and then I can best tell you what I would suggest.
The American Society of Plastic Surgeons has a web site with a lot of good general information on breast augmentations. It is at plasticsurgery.org. The two largest manufacturers of breast implants also maintain websites – breastimplantsbymentor.com and natrelle.com. Implantinfo.com is another site with before and after photos for breast implants.
Before and After Photos
Patient A
This young lady was 5’3” tall, and weighed about 120 pounds. She was very athletic and did not want her breasts to interfere with her athletics. She had 200cc smooth saline implants placed through her armpits. She is shown one year later and is still able to do all of her athletics, and even go braless!
Patient B
5’7″ tall, 130 pounds. The implants are size 300 filled to 325. They were placed through and incision in the armpit.
Patient C
5’4″ tall, 150 pounds, subglandular, textured McGhan tear drop, size 360 filled to 300 implants. This young lady actually had a fair amount of breast tissue, but after breast feeding lost a lot of volume. She elected to have that volume restored using a textured anatomical shaped implant that was placed underneath the breast tissue and on top of the muscle.
Patient D
5’5″ tall, 110 pounds. These implants were placed through a transaxillary incision (armpit) under the muscle, and were about a 350 filled to 365 and 390.
Patient E
This very fit 26 year old is 5’7″, 115 pounds. She works out on a regular basis and has a wonderful but physically demanding job. She wanted to continue to wear most of her old clothes, but also wanted to increase the variety of tops that she could look great in. She has a submuscular implant that is around 320 ccs placed through an armpit incision.
Patient F
5’0″, 100 pounds. Transaxillary, submuscular, using a Mentor siltex saline implane size 300, filled to 350. How you look “after” really depends on how you look “before!” This young lady has breasts that are very high and perky “before” surgery, and after surgery her breasts will tend to be high and perky. I used the siltex implants that are textured – they not only look firmer than the smooth implants, they also feel firmer.
Patient G
5’6”, 140 pounds, 310 submuscular saline implants. This hard working twenty something felt like she just wanted to add some oomph to her breasts. Sassy, not trashy! So she opted for just a 300 saline filled implant placed underneath the muscle, through a virtually invisible one inch scar in her armpit. This provides a teeny bit more bounce to her step. So nice and naturally soft.
Patient H
5’10”, 138 pounds. 365 submuscular saline implants. This young lady was very tall and slender. After the kids, she had lost the breast volume, and basically was stuck with padding her bra, her swim suit, her T-shirt. Well, you get the idea. She just wanted a very natural look. After surgery, it just simplified her life. She could just throw on a t-shirt and go.
Patient I
5’5”, 170 pounds, 750 submuscular saline implants. Everyone in her family was a D cup! What happened? She felt very disproportionate. After surgery, she felt much more in proportion with her hips, and the rest of her family.
Patient J
5’7”, 127 pounds, 200 silicone gel implants MMP. She had beautiful breasts in a push up bra, but just wanted to be able to go braless sometimes, and not always have to wear a bra. So she opted for an enhancement. These were silicone gel implants, but they were placed through an armpit incision, leaving no incisions on her breasts. This just makes it easier if one is wearing a triangle bikini.
Breast Asymmetry
This young lady has beautiful breasts, but would like to have them be fuller. If you look closely, and sometimes you almost have to look at the photos upside down, you can measure the amount of skin showing between the botton of the areolar and the bottom of her breast. It is different on the right and the left breasts. In short, the right breast is lower than the left breast before surgery – so it will be slightly lower after surgery as well. It may even appear more obvious, as her breasts are enlarged – just like putting yourself on a xerox machine and zooming in – any discrepancy will be magnified. The amount of difference is normal though, nothing on the body is the same on each side – which makes us human.
Pectus Excavatum
This young lady was born with a pectus excavatum, which is a congenital formation of the rib cage and sternum. The sternum actually goes in, and sometimes can cause compression of the heart. This young lady, however, had no functional deficits, but the aesthetics of a flat chest combined with a pectus excavatum, proved difficult to conceal even in clothing. The breast augmentation successfully camouflaged this problem and made it easier to buy clothing.
Poland’s Syndrome
This young lady has Poland’s Syndrome – congenital absence of the breast and, in her case, the pectoralis major muscle. In one operation, she had a small implant placed on the left and a larger saline implant placed just up underneat the skin on the right. The has provided her with a satisfactory result that has lasted and lasted! The right has a 375cc smooth saline and the left has a 150cc implant.
Tuberous Breast
Sometimes the breast tissue herniates into the nipple resulting in the breast tissue looking more like a “tuber” or root, rather than a more normal spherical form. This is very difficult to correct, and the correction usually requires an implant. This young woman’s right breast has a very tight inframammary fold and the breast tissue here is all up inside the areolar. The skin envelope is very tight, which is best seen from the side view. The base of the breast was released, and the saline implant placed partially under the muscle and partially under the skin to achieve this result. In addition, the size of the areola was reduced to more closely match the left breast. The left breast had a standard submuscular augmentation. She is about 5’1″ tall and weighs around 130 pounds. Both implants are size 275.