The patient is a 36 year old woman who noted loss of tone and fullness of her beasts after pregnancy. She wished breast augmentation with silicone gel implants to get a better shape for her breasts. At her initial consultation she tried on implants with a special implant bra and liked 360 cc. Different implants types were discussed and at surgery approximately 360 cc. gel implants were placed, with slightly larger volume on the right to achieve symmetry.
Postoperatively the patient was very happy with her cosmetic result. She loved the upper pole fill the implant gave her from muscle support and this will give her cosmetic result great longevity and prevent long term bottoming out that can occur when the implants are placed above the muscle or when the muscle has been released and can’t support the weight of the implant. When patients are young the skin is thick and resilient and can support the implant without the support of the muscle. But as patients age, the skin thins and those patients that have implants above the muscle or who have had muscle detachment during their initial surgery lack support and the implant can descend and this not only leads to drooping with a lower implant but also loss of upper pole fullness can occur. That why it is critical to have breast implants placed under the muscle . The muscle also provides extra cover to decrease the ability to be able to feel or see the implant.
