Patient 11 Gallery

Before and after breast augmentation in a 26 year old woman with hypomastia (congenitally underdeveloped or disproportionately small breasts) and a tubular breast shape.  She also had a hypertrophic left nipple that required a nipple reduction to achieve symmetry with her right nipple. 

She shows many of the hallmarks of a tubular breast deformity, including a small breast size, enlarged and puffy areolas, a high inframammary fold (the fold under the breast) which leads to the appearance of droop even though the breast is small.  This is called “pseudoptosis” of the breasts. 

She just wanted “to look normal”, have a natural looking result and to be able to fill out a bra.  She was very physically active and did not want anyone to know she had surgery. 

A breast augmentation was performed to fill out her breast envelope and to create a more proportional breast size with her body.  A smooth round silicone gel breast implant was placed on top of the muscle, in the subglandular position. 

A nipple reduction was performed on the left so that it was the same size as the right.  The remaining nipple maintains connections to the areola and the breast so that breast feeding should be possible in the future. 

Follow up photos are shown at 4 weeks after surgery.  She is back at work and exercising regularly.  She feels “like they belong to me” and is very comfortable in her body.  She feels “these are the breasts I was meant to have”.  Which is exactly what we were going for! 

Her left areola is still a puffy, as we did not adjust her areola as part of her procedure.  A periareolar mastopexy was discussed with her as an option, but she opted to not have a scar around her areola to push the protruding areola tissue backward. 

The best surgical plan takes as the first priority the PATIENT’S individual goals.  There is no one-size-fits-all approach.  She understands she can have the puffy areola corrected at a later date if she wishes, in the office under local anesthesia.