Before: 30 year-old female, 5'7" 127lbs, full A cup breasts with preexisting sag (ptosis) and asymmetry due to nursing two children

After: 8 months post-operative, 450cc silicone gel high profile implants, with associated bilateral areolar lifts to small D cup breasts

Comments: This patient desired the equaling of her breasts size (the right breast was quite a bit smaller), the elimination of her sag, and no degree of roundness on the upper breasts. As she needed a small lift at the same time as the augmentation, this made her a candidate for the silicone gel implants. Her overall shape (natural slope) in all three post-operative views is quite nice.

Before: 22 year-old female, 5'8" 134 lbs, A cup breasts

After: 8 months post-operative, 450cc smooth round saline implants, to full C cup breasts

Comments: This patient wanted to close the very wide gap between her breasts for natural cleavage, and have a fullness on each side of the upper breasts. I achieved this while maintaining a natural result.

Before: 23 year-old female,  5'7" 127 lbs, A cup breasts

After: 1 year post-operative, 475cc smooth round saline implants, to small D cup breasts

Comments: This patient wanted very natural looking D cup breasts on her fairly narrow chest wall. I met her expectations with a natural slope (notice the angled view) a nice natural cleavage.

Before: 25 year-old female, 5'6" 116 lbs., A / B cup breasts

After: 6 months post-operative, 475cc saline implants, to D cup breasts

Comments: Once again, notice that larger volume implants on a smaller upper torso tends to result in more roundness in the upper pole of the breasts.

Before: 28 year-old female, 5'6" 135 lbs, B cup breasts

After: 8 months post-operative, 475cc smooth saline implants, to small D cup breasts

Comments: This patient wanted the appearance of a lift without actually having one. Although she looks broader than she actually is because the picture was taken showing less black background, her pre-operative shape is somewhat typical of someone with a small amount of sag (position of nipples relative to lower breast fold.
The key here was increase the distance between her nipples and her natural lower breast fold. I used a generous volume but was still able to achieve a natural slope in the upper part of the breast.

Before: 29 year-old female, 5'5" 125 lbs, significant pre-existing asymmetry and tubular deformity

AFTER:  8 months post-operative, 390cc (right) and 420cc (left) smooth Saline implants

COMMENTS:  This patient desired to go as full as she could while still looking natural. Knowing her right areola would still be wider than her left, I performed an areolar lift for the tubular right breast without the additional standard lift anchor-type scar. Although this surgery posed many challenges due to her significant asymmetry and deformity, she was extremely pleased with the overall improvement.

Before: 32 year-old female, 5-6 124 pounds, "A" cup breasts (nursed two children)

After: 1 year pos- operative, 450 cc smooth saline implants (to small "D" cup breasts)

Comments: This patient wanted to go as full as she could while maintaining a natural look with a slight hint of roundness (high profile) of the upper breasts (front view).

Notice on the pre-operative picture where the nipple and areola are close relative to the lower breast fold. I added generous volume, and centered the implant behind the nipple/areola – which is an important relationship so that the nipples don’t point downwards.

BEFORE:  28 year-old female, 5'5"  132 lbs, small B cup breasts

AFTER:  8 months post-operative, 425cc smooth Saline implants, to full C / small D cup breasts

COMMENTS:  This patient desired her breasts to be even (the right was slightly higher) and the wide gap between the breasts to be narrowed with a fuller appearance. These goals were achieved while maintaining a natural slope of the upper part of the breast (see angle and side view).

BEFORE:  31 year-old female, 5'3"  108 lbs, pre-existing silicone breast implants (by another surgeon 10 years ago in Utah), B cup breasts with significant asymmetry

AFTER:  8 months post-operative, old silicone implants replaced with 425cc high profile Silicone implants, to small D cup breasts

COMMENTS:  This patient presented a challenge in that she had pre-existing asymmetry with the implants she already had, and her left breast was narrower. She opted to have her previous implants replaced with moderately larger silicone implants. Notice the natural slope (in the side and profile views). The patient's frame looks broader post-operative, due to the photograph's somewhat "zoomed in" view.

BEFORE:  33 year-old female, 5'5"  135 lbs, small B cup breasts after nursing 2 children

AFTER:  8 months post-operative, 420cc smooth Saline implants, to small D cup breasts

COMMENTS:  This patient wanted a very natural slope in the upper part of the breasts, which I accomplished (as seen in the two views). I also positioned the implants so the patient had the appearance of a small lift without actually having one—meaning no additional scars.

BEFORE:  27 year-old female, 5'6"  123 lbs, A cup breasts

AFTER:  7 months post-operative, 425cc Saline implants, to full C cup breasts

COMMENTS:  This patient had very small areolas, but I performed the operation through the standard periareolar incision (junction of lower part of areola and normal breast skin). I added a generous volume for her frame, but still achieved a natural slope to the upper part of the breasts.

BEFORE:  26 year-old female, 5'4"  113 lbs, small B cup breasts and pre-existing sag due to weight loss

AFTER:  9 months post-operative, 450cc smooth Saline implants, to small D cup breasts with bilateral areolar lifts

COMMENTS:  This patient lost over 35 lbs so her breasts had somewhat of a "boxy" shape, as well as a fair amount of pre-existing sag (ptosis). Due to her ethnic background (Asian) and her concern about scarring with a traditional lift (anchor-type scar), she opted for a modified areolar lift. She received the appearance of a lift, but avoided the additional scars. Her shape is still somewhat "boxy" after the procedure, but that is a limitation of a standard breast augmentation in someone with this shape. The patient was very pleased with the overall result and the natural slope obtained (as seen in all views).

BEFORE:  23 year-old female, 5'8"  127 lbs, A cup breasts with pre-existing bilateral tubular breast deformity and significant asymmetry

AFTER:  7 months post-operative, 450cc smooth Saline implants, to full C cup breasts with reconstruction of tubular breast deformity

COMMENTS:  This patient poses one of the more challenging types of aesthetic breast procedures with the degree of her deformity and asymmetry. Using a generous volume implant, I lowered her natural, shortened crease at the same time, for an overall improvement with a natural appearance.

BEFORE:  25 year-old female, 5'3"  104 lbs, A cup breasts

AFTER:  8 months post-operative, 425cc smooth round Saline implants, to full C cup breasts

COMMENTS:  This obviously very small patient desired a hint of roundness in the upper part of the breast (rather than a natural slope), and a fair amount of natural cleavage. I achieved this very nicely (see the extra fullness of the upper breasts in the angled view).

BEFORE:  33 year-old female, 5'5"  130 lbs, small B cup breasts after nursing 3 children

AFTER:  10 months post-operative, 425cc smooth round Saline implants, to mid / full C cup breasts

COMMENTS:  This patient had a fair amount of loose skin with her pre-existing sag. I achieved the effect of a small lift, without removing any skin, by slightly lowering her natural crease and using a nice size implant. Notice the natural slope in the upper part of her breasts.

BEFORE:  32 year-old female, 5'8"  132 lbs, A cup breasts with asymmetry after nursing 2 children

AFTER:  10 months post-operative, 425cc smooth round Saline implants, to full C cup breasts

COMMENTS:  This patient wanted a very natural look with no roundness in the upper part of the breasts. I corrected the asymmetry gave her a very natural slope in the upper part of the breasts. This patient had a fair amount of asymmetry of her breasts to begin with—something I see in a very large percentage of patients, especially those that have nursed children.

BEFORE:  30 year-old female, 5'4"  118 lbs, full A cup breasts after nursing 3 children

AFTER:  7 months post-operative, 275cc smooth round Saline implants, to full B cup breasts

COMMENTS:  This patient wanted to eliminate the loose skin of her obviously sagging breasts. As I did not perform any kind of lift procedure, she expected this result after seeing other patients with her kind of pre-existing breast anatomy.

BEFORE:  36 year-old female, 5'7"  135 lbs, small B cup breasts with ptosis (sagging) of breasts after nursing 3 children

AFTER:  9 months post-operative, 425cc smooth round Saline implants, to full C / small D cup breasts

COMMENTS:  This patient desired only a breast augmentation, although she really would have benefited from some type of lift procedure (one of the various options I presented her but she wasn’t comfortable undertaking). She was very pleased with the result, given how much sag I eliminated.

BEFORE:  34 year-old female, 5'9"  133 lbs, B cup breasts with significant asymmetry

AFTER:  10 months post-operative, 425cc smooth round Saline implants, to full C cup breasts

COMMENTS:  This patient presented somewhat of a challenge because her right breast was higher and smaller than the left, but that’s why intra-operative sizers are important. I corrected the pre-existing asymmetry while maintaining a very natural appearance to her breasts.

BEFORE:  33 year-old female, 5'7"  129 lbs, A cup breasts with asymmetry after having 1 child

AFTER:  10 months post-operative, 450cc smooth round Saline implants, to full C cup breasts

COMMENTS:  This patient had a smaller and narrower left breast than right. She wanted a very natural look and a natural cleavage, yet wanted to go as full in volume as possible. The angle and side views show I achieved the size she desired with a very natural slope to her breasts.

BEFORE:  32 year-old female, 5'6"  124 lbs, full A / small B cup breasts after nursing 1 child

AFTER:  1 year post-operative, 475cc smooth round Saline implants, to full C / small D cup breasts

COMMENTS:  This patient wanted to go as full as she could go in volume and yet still look natural, without a hint of roundness at the upper part of the breasts. 475cc is a good size implant but I created a very natural look (especially seen in the angle and side views). Note that probably over 95% of women have, to some degree, asymmetry.

BEFORE:  28 year-old female, 5'6"  125 lbs, small B cup breasts

AFTER:  1 year post-operative, 625cc high profile smooth round Silicone gel implants, to full D cup breasts

COMMENTS:  This patient wanted very full-sized breasts and an ample cleavage that appeared natural. I achieved her expectations with a very nice shape. It was necessary to use an inframammary incision (which I typically don’t) because I couldn’t fit the large size implant through a periareolar incision. The inframammary incision takes about 1 and 1/2 years to fade.

BEFORE:  26 year-old female, 5'9"  132 lbs, small A cup breasts

AFTER:  7 months post-operative, 430cc high profile smooth round Saline implants, to mid / full C cup breasts

COMMENTS:  This very thin patient had a narrow upper chest diameter and little breast tissue. She desired a more rounded appearance to her breasts—what I refer to as more of an “augmented” look. I chose the high profile implant because her breast base diameter was so narrow, and it  decreased the likelihood she would get "rippling".

BEFORE:  23 year-old female, 5'3"  112 lbs, B cup breasts

AFTER:  11 months post-operative, 450cc high profile smooth round Saline implants, to D cup breasts

COMMENTS:  This patient had a small frame, although the pictures do not show it, and a very narrow breast diameter. At first glance, she looks like she has much larger implants in the post-operative pictures. Remember, she had a fair amount of pre-existing breast tissue with her small measurements. Her breasts would have looked too wide with standard moderate profile implants.

BEFORE:  36 year-old female, 5'7"  137 lbs, small B cup breasts

AFTER:  1 year post-operative, 450cc smooth round Saline implants, to full C / small D cup breasts

COMMENTS:  This patient had a long distance between her clavicles and nipples; therefore, I easily obtained a natural result even with the good-sized volume implants. I created a pocket under the pectoral muscle to center the implant behind the nipple and areola.

BEFORE:  34 year-old female, 5'7"  142 lbs, small C-cup breasts with significant sagging (ptosis) and associated significant asymmetry after nursing 3 children

AFTER:  6 months post-operative, 425cc smooth Saline implants, to mid D cup breasts with full mastopexies (bilateral lifts with anchor-type scars)

COMMENTS:  This patient needed a full lift on each side (mastopexy). If I had performed a straight lift without augmentation, she would not have received the fullness in the upper part of the breasts that looks so natural from all views. She is only 6 months post-operative, so her scars are still fading and will do so much more.