Background: The popularity of breast augmentation surgery has much to do with its immediate effect at creating a larger and fuller breast mound. As the number of breast augmentation surgeries have continued to increase over the past decade, ‘older’ women are more frequently having the procedure. While once thought of as just a cosmetic procedure for younger women who never developed much breast tissue, more older women (50 years or older) are getting breast implants as a rejuvenative body change.
The look of a woman’s augmented breast is highly dependent on what the breast mound looked like beforehand. The best results from implants occur in breasts that do not have too much loose skin (no ptosis or sagging), have a centrally or near central mound position of the nipple-areolar complex and do not have extensive stretch marks or prominent veins. With this anatomy, mound inflation produces an aesthetically pleasing breast appearance. This can be appreciated if you look carefully across the internet at a lot of before and after breast augmentation results. The best looking results come from those women with the most favorable presurgical shape of their breasts.
Most older breasts do not have many of the desired anatomical features for ideal breast augmentation results. Breast sagging, low nipple position and stretched out skin lead to the need for some type of lift and tightening procedure to be done in conjunction with implant placement. It is the exception that breast implants alone can be done in an older patient.
Case Study: This 55 year-old female had never wanted breast implants when she was younger. When she was younger her thin body frame and fuller breasts were aesthetically satisfactory. But the combination of having children and age left her with a deflated breast appearance on a thin skeletonized body type. She wanted an implant size that was ‘body proportionate’ and not too big.
Under general anesthesia, she had form-stable silicone gel (aka gummy bear, Sientra) implants of 400cc volume placed through small (3.5 cm) lower fold incisions in a one hour procedure. Her favorable breast anatomy made for an immediately well rounded mound with small and centrally located nipples.
She was placed on the Rapid Recovery Breast Augmentation program which emphasizes an early and aggressive physical therapy approach. This enable her to return to work in less than one week after surgery.
It is important for any women considering breast augmentation that they understand what an implant can actually do. It does not have any magical lifting properties on the breast mound. With good nipple position, the breast can appear to be lifted but the actual nipple position does not really change. In the older women with good mound characteristics, implants can have a remarkable breast rejuvenative effect.
Case Highlights:
1) Breast implants provide instant volume to a small or deflated breast.
2) How an augmented breast looks has much to do with the quality of the breast mound beforehand including the shape of the skin and the position of the nipple.
3) In the older female chest that has favorable anatomy, breast augmentation can have a dramatic rejuvenative effect.
Dr. Barry Eppley
Indianapolis, Indiana