A woman in her mid 20’s with a tuberous breast deformity. She is bothered by the shape and also the size of her breasts. She wanted to be fuller but still natural in appearance. With a Tuberous breast, the base of the breast is relatively constricted and narrow and needs to be expanded. The breast is overly “pointy” and needs to have the shape flattened a little. A periareolar round block gortex suture flattens a tuberous breast and improves the shape. She is 5’5’ and 132 lbs but the base width of her breast is just 10.7 cm on her right and 10.5 cm on her left. The inferior areola to the breast fold distance is just 5 cm. So an implant needs to be carefully chosen that will widen the base of the breast but not be too large for the new nipple to breast fold distance which with reduction of the areolar with a gortex suture would be 7 to 7.2 cm. This would suggest based on the geometry that an implant with a base width of 11-11.2 cm is the widest that can be used without needing to lower her breast fold. Lowering the fold increases the risk of “bottoming out” and also of a “double bubble”.
She elected for the Ideal structured saline implant and so the 300 cc implant was selected. This has a base width of 11.1 cm so it is just a little wider than the base of her existing breast which helps to widen the base of the breast, but is not too large for her new nipple to fold distance after her periareolar round block suture is placed. The implant was placed in a subglandular plane.
The 300 cc implant has an empty implant volume of 37 cc due to the internal baffles, and the back/inner lumen is designed to be filled to 188 cc. The front lumen can be filled to 75 cc to give a moderate profile and total volume of 300 or to 115 cc to give a high profile and a total volume of 340 cc.. In her case a moderate profile has a better effect and the implant was filled to 300 cc total volume. She is shown before and again, 7 months after surgery.
The scars around the areola will typically continue to fade and improve over the first 2 years after surgery. She is already thrilled with her new shape and size. It would have been difficult to use a larger implant in her case and still maintain a natural appearance because of the tissue dimensions of her breast.