Breast Gallery
Breast Aug with Lift
Description:
23 year with 4-year-old son had met two of my previous patients. Happy with her breast before her pregnancy but now sagging. Wants to be “restored’ better in bathing suit, look better naked without bra and wants a lift because of the sagging.
Exam 5’ 4 ½” 128 lb. now 34C although can wear a 34 B+ a B is too small. Exam revealed grade II ptosis (drooping where the nipple hung below the fold under the breast) and diffuse pale stretch marks.
In office sizing with a brassiere and sizer implants showed her preference for 450 cc implants was consistent with the photos she brought demonstrated her ideal outcome.
Surgery with the “short scar” breast lift (mastopexy) with sub muscular 450 cc moderate profile textured silicone implants.
Initially there was excessive fullness of the upper breast reduced with stretching exercises by the patient and a breast strap over a 4-week period.
Post operative photos 3 months after her surgery. Nipple and skin sensation intact. Very happy with outcome and 34 DD size. She has referred two friends to the office.
Pink incision color fades and other slight irregularities typically settle within 12-36 months after breast lift surgery.
Breast Tuberous 01a
Description:
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).
Operation:
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.
After surgery:
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.
Inverted Nipple 01
Breast Revision 01a
Breast Revision 03a
Description:
Patient happy with size C+ but after two childbirths had atrophied to A+. She underwent surgery with another doctor: breast augmentation with limited breast lift. Saline implants were placed under pectoralis muscle R 250 cc and L 300 cc.
Only 2.5 years later she presented to Dr. Pertsch noting the implants seemed too high and her breast tissue seemed to be sliding off the implants. She had undergone only a limited “circumareolar” or so called “donut” mastopexy by the other surgeon and the breast drooping had reoccurred quickly.
Exam consistent with 5’5 ½” 130 lb. 34C size now age 39 yrs. Pre-op photos reveal breast tissue sagging off of implants that were relatively high on the chest.
Dr Pertsch performed a complete breast lift on both. A small amount of breast tissue was removed to during glandular reshaping to give a longer lasting result. 36 gms of tissue were removed from R and 57 gms removed from the L. The R breast seemed slightly larger before this surgery so 25 cc of saline was added to L breast implant to improve symmetry. Original implants (only 2 years old) were placed in a slightly lower position on the chest wall (an inferior capsulectomy allowed implants to settle). Photos taken 2 years and 4 months after Dr. Pertsch’s surgery. 5’5 ½” 135 lb. 36C (almost D) but happier with improved shape. Breast felt very soft as implants remained very mobile within their pocket.