Breast Tuberous 01a
Breast Tuberous 01a
20 year old wanted to “be normal”. Main concern was to even out, fuller and same size on each side noting R now bigger than left. Just wants “perky and normal like a 20 year old”. Patient never dated after a first boyfriend made fun of her physique.
Exam: Tuberous breasts where most breast tissue herniated into large areola (flat colored breast skin) and not spread out normally over the chest. 5’ 8” 130 lb. 32 B or C with L side stuffed. Timid demeanor.
Asymmetry: Size and shape differences.
Right side ~ 30 cc larger and Grade II ptosis (nipple below level of fold under breast).
Left side Pseudo-ptosis (“false” drooping: nipple above the level of the fold under breast but, from front view, cannot see breast all the way under to where it joins chest wall).
Allow areola to be flatter: remove breast tissue from deep behind areola 55 grams right and 32 grams left to improve symmetry
Allow breast tissue to flatten: breast glandular reshaping by release tissue radially from inside so it would relax and spread over larger area.
Normalize proportion: Subpectoralis muscle “dual plane” breast augmentation with gel high profile 616 gel implants
Reshape skin removing excess areola and skin near areola to give even more normal breast shape: mastopexy breast lift) with incision around areola and vertically down.
Initially breast had a very flattened appearance below areola “In a T shirt there is no underside to my left breast!”
10.5 months after surgery: Now 21 yrs. 5’ 8” 144 lb. 34 D scars red and still stretching out. R nipple remained flat when stimulated and had less sensation. “OK to show photos to patients in the office”
2 yr. 9.5 mo. after surgery photos taken: 23 yrs. 5’8” 125 lb. 32 or 34DD fit best. Sensation normalized and tissue relaxation had further improved breast shape. “OK to show photos on the internet”
“Thrilled, steady boyfriend and normal life.”
Before she left she insisted I see her fully dressed eye catching, head turning, statuesque 5’8” 125 lb. in 4” heels and short, black, form fitting dress. I marveled again at the unleashed psyche after figure flaw improvement.