38 year old single physically active graphic artist, 5’7” tall for Breast Augmentation, Oceanside, CA presented for natural appearing breast augmentation. 420 ml textured saline Implants placed in submuscular position via Inframammary approach. Bra cup size from A to C
Note the widely spaced nipples before augmentation, and space between breasts. Patients with this situation are prone to have a wide space between their implants after augmentation, which can create an artificial appearing result. Point of Information (Widely spaced nipples or implants too narrow for base width of breast can result in artificially appearing wide space between breasts after augmentation). During breast augmentation using round implants, the center of the implant must be placed behind, or nearly behind, the nipple. If the nipples are far apart before augmentation, as in the patient above, the implant must be very wide for the implant edge to reach the center of her chest, thus creating cleavage. If an implant this wide is chosen, the other (lateral) side of the implant will reach around beneath her arms, interfering with mobility of the arm, and extending the breast to an abnormal position on the side of her body. Thus, women with widely spaced nipples who have augmentation with round implants, are predisposed to an abnormally wide space between the implants. It is difficult or impossible to create natural appearing cleavage for these women. To avoid this artificially appearing "intermammary distance," the surgeon often "centralizes" implants, placing them slightly more toward the center of her chest. An abnormally wide space between implants can also result from use of implants too narrow for a woman's pre-existing breast. This is why, in planning for breast augmentation, it is critically important for the surgeon to measure the width of the patient's breast. From this "base width," the appropriate width of the implant is chosen. If the implant is too narrow for the breast and is centralized behind the nipple, a wide intermammary distance (distance between the visible inner edge of the breasts) results.
