Abstract
Dr. Slavin: Some of the most important recent advances in breast surgery have involved modification of the traditional incisions that we use for breast augmentation, mastopexy, augmentation combined with mastopexy, and moderate-size breast reductions. Nationally, we are witnessing an increased demand for these different minimal incision breast surgery procedures. The first patient is a 29-year-old woman who is seeking an enlargement from her current bra size of C to a D (Figure 1). Dr. Grotting, is she a good candidate for a breast augmentation, and how would you perform this? Figure 1 A 29-year-old woman seeking breast augmentation from her current bra size of C to a D. A , Frontal view. B and C , Lateral views, left and right breasts. Dr. Grotting: This patient's request reflects a rather common problem that I see. I believe many women are under the impression that adding a breast implant can completely correct an aesthetic shape problem. This is a patient who has an adequate volume of breast tissue that is consistent with her lower body habitus. However, to me, the problem is primarily one of breast shape. I would try to educate this patient about what a breast implant would do for her as opposed to a mastopexy and would encourage her to consider a mastopexy procedure alone rather than an augmentation mastopexy. Dr. Slavin: Dr. Goes, can you improve this patient's appearance with an enlargement alone or would you need to add a skin tightening procedure? Dr. Goes: The right breast is a little more ptotic and a bit bigger than the left breast. I agree with Dr. Grotting on the need to correct the ptosis and to improve the symmetry of both breasts. If the patient really wanted augmentation, I would perform it through a periareolar incision. Sumner A. Slavin, MD …
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