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Background: Breast augmentation remains one of the most popular body contouring procedures due to its effectiveness and universal application. Provided one has a favorable breast mound that does not have any sagging and a nipple position above the inframammary fold, an improved breast size and shape will result. This applies equally to all ethnicities as well as genders.

While an implant can successfully enlarge the breast, it does not always solve all of its aesthetic issues. It takes the existing breast mound and enlarges whatever its natural shape is. This takes on great relevance since there are two breast mounds and it is the exception rather than the rule that they are exactly similar. While small breast differences may not even be known or seem inconsequential, they can take on greater visibility and aesthetic significance when they become enlarged by an underlying implant. It is always best that patients assume that some asymmetry between the breasts after implant augmentation will be the result.

From an ethnic standpoint there aren’t really any technical differences in how breast augmentation is performed. The lone exception is scar visbility which in patients with more skin pigment may be less tolerated and can influence the choice of incision location.

Case Study: This middle-aged African-American female wanted breast implants for her naturally small breasts. There was some asymmetry to them despite their small size with the right breast having a lower and more defined inframammary fold.

Under general anesthesia and a 2 cm skin incision in a high axillary crease, 275cc saline implant were placed and inflated to 300ccs in a near complete submuscular pocket in a 35 minute operation.

Notice in her six week result the differences in the lower portion of the breast mounds which reflect the preoperative differences in her breasts. They have different shapes along the inframammary folds which she notices but was not a concern to her.

Case Highlights:

1) Breast augmentation can be done successfully in any ethnicity regardless of age.

2) Breast implants consistently enlarge or make more obvious whatever asymmetry exists between the breast mounds no matter how slight it may initially be.

3) Transaxillary saline implants offers the most economic and efficient form of breast augmentation.

Dr. Barry Eppley

Indianapolis, Indiana

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