This patient in her 40s was 167cm tall, weighed 60kg and wore a 34B bra preoperatively.  She developed skin laxity and loss of upper breast fullness after breastfeeding, and she was seeking a significant size increase. The nipples had a sagging appearance, yet by measurements they were not excessively low for her body proportions (SN-NAC, sternal notch to nipple distance, was only 20.5cm on the left and 21.5cm on the right). Therefore, the reason for the ptotic appearance was actually high inframammary folds a short nipple to inframammary fold distance (NAC-IMF only 5.5cm). In this scenario, rather than performing a breast lift, one can lower the inframammary fold to help fill out the lower pole of the breasts. Although this technique does not technically elevate the nipple position, it helps to fill out the lower poles while avoiding mastopexy scars. The subfascial pocket was chosen to ensure the lower breast tissue would expand over the implants. This is one of the main advantages of the subfascial pocket, although patients should be advised that the implants might be more visible or palpable when they are placed in front of the pectoralis muscle. She chose 415cc smooth round full profile highly cohesive Truform III silicone gel implants to retain their roundness and maximize upper breast fullness. The breast implant postop photos were taken at the 6 week follow-up visit.
Breast implants:Â 415cc smooth round full profile highly cohesive silicone gel.
Scar location: Inframammary
Implant pocket: subfascial
Breast base width: 13cm
Disclaimer: Similar results cannot be guaranteed since outcomes vary among patients
