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Case Study – Breast Augmentation in Widely Spaced Breasts

 

Background: The outcome of breast augmentation is affected by many variables that go far beyond the implant itself. The shape and position of the breast mound and its nipples profoundly impact how they will look when the implants are placed behind them. Too often patients believe that the enlarging their breasts will correct many of their undesired flaws.

One undesired feature of some breast augmentation patients is the wide spacing between the breast mounds. This wide sternal gap can be caused by a horizontally wide bony sternum, breast mounds that are positioned very lateral on the chest wall or a combination of both. The position of the nipples is the giveaway as to why the breasts are wide. If the nipple is at ir more lateral than a vertical line drawn down from the mid-clavicular point, then it is the laterally positioned breast mounds that are at fault.

Getting the breast mounds closer with implants can provide improvement. This is better achieved with implants in the subglandular position as the medializing effects of submuscular implants is limited by the position of the origin of the pectorals major muscles at the edge of the sternum.

Case Study: This 25 year-old female presented for breast augmentation surgery. Her biggest concern was that she did not like the wide spacing between her breast mounds.

Under general anesthesia she had smooth silicone breast implants placed through inframammary incisions. The implants were of 325cc size. Her after surgery results show less width between the breast mounds and a filled in effect of the medial poles of the breasts. But the nipples still look very lateral on the breast mounds.

It is important in preoperative counseling of the breast augmentation patient that wide spacing between the breasts will not be completely eliminated. Equally relevantly the nipples of the augmented breast mound will remain at the lateral edge of the breast mound and their position will remain unchanged regardless of implant size.

Highlights:

1) Widely spaced breasts poses aesthetic challenges in breast augmentation.

2) While the inner breast mounds can be enlarged and create decreased mound spacing, the position of the nipples will not change.

3) The fundamental concept in breast augmentation is that implants merely take what the natural anatomy is and make it bigger…but it is not a total reshaping of the breast.

Dr. Barry Eppley

Indianapolis, Indiana


Dr. Barry EppleyDr. Barry Eppley

Dr. Barry Eppley is an extensively trained plastic and cosmetic surgeon with more than 20 years of surgical experience. He is both a licensed physician and dentist as well as double board-certified in both Plastic and Reconstructive Surgery and Oral and Maxillofacial Surgery. This training allows him to perform the most complex surgical procedures from cosmetic changes to the face and body to craniofacial surgery. Dr. Eppley has made extensive contributions to plastic surgery starting with the development of several advanced surgical techniques. He is a revered author, lecturer and educator in the field of plastic and cosmetic surgery.

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