plastic surgery nyc breast augmentation

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plastic surgery nyc breast augmentation

you're listening to dr. carlin vickery from5th avenue millennium surgery. this is dr. carlin vickery, i am talking abouta patient who is a 41-year-old woman who presented to me having been diagnosed with ductal carcinomain situ of the right breast. the patient, after having a full-course of chemotherapy,elected to have bilateral mastectomies and immediate implant breast reconstruction. on the front view you can see, in her pre-operativephotographs, that the patient has small c to large b sized breasts and that she hasless fullness in the upper pull of her breasts than in the remainder of her breasts. thepatient will undergo a nipple and areola sparing breast reconstruction.

the breast surgeon will make an incision aroundpart of the areola and extended out towards the armpit so that complete removal of thebreast can be performed at the time of surgery. on the side view of this patient you can seethat the lack of upper pull fullness is demonstrable and that she has essentially b sized breasts.the nipple and areola are in an excellent position for implant breast reconstructionas they are neither too low and the breasts are not so large that she will have a largeskin envelope, which would make reconstruction more difficult. in the postoperative face on photograph, youcan see the incision which is still evident on the outer aspect of the breasts. this willundergo a lightening process over ensuing

months and at this time is more noticeablethan it will be at 6 to 12 months. the overall shape of the breasts fills theskin envelope adequately and covers the upper portion of the chest wall in a very naturalmanner. there is no evidence of rippling or any deformity in the upper pull of the breastand there is a nice, natural shape and symmetry between the right and the left side. also on the front view, the patient demonstratesa very natural, pleasing cleavage in the midline of the breast. on the oblique view, one cansee that the patient has a very natural take off from the implant which extends from herupper chest wall down to the natural inframammary fold and the nipple and areola position isover the maximum point of projection of the

implant, giving a very youthful, appealing,natural result. again, the incision which is evident in thesephotographs is within a month post op and this will continue to undergo lightening asthe patient gets past the initial healing period. both of these photographs demonstrate theoptimal result one can achieve if a patient is a candidate for a nipple areola sparingmastectomy. the reason for this is that the skin envelope that is maintained followingthe mastectomy allows an ideal reconstruction and there is no tension across the underlyingimplant. this gives a very natural, pleasing result and combined with the use of allodermin the upper pull of the breast, many of these

patients will have completely smooth, naturalreconstructions. visit us on the web at www.5thavesurgery.com.

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cleavage is a very, verycommon question that patients ask me about. i think that, you know,in clothing, in a bathing suit,there's a lot of femininity that goes along with thatsilhouette of nice cleavage. it's a very big concernfor a lot of my patients and i basically assume noweverybody wants nice cleavage. it's very rare thatsomebody comes in and goes, look, i want my breastswidely spaced apart please, just like tori spelling. okay. that just doesn't happen. the thing is-- is thatcleavage is very dependent on your own anatomy. for example, if you putthe implant under the muscle, the muscle comes across andit inserts into the chest bone. so, if you have musclesthat insert close together, you're gonna gettighter cleavage. if you have musclesthat insert wider apart, the cleavageis gonna be wider. wheneveri get under the muscle, i'm always tryingto bring the implants as close togetheras possible. i actually liftthe muscle a little bit. but you can't strip
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in this operation we're going tobe carrying out a bilateral breast augmentation, partially under the muscle, using allergantrm, which are the moderate profile implants. i'll be taking you through each stage of theoperation. we're going to make a small incision in the inframammary fold, make sure that measuresjust under five centimetres. then i'm going to go under the breast tissue here and thenfind the muscle, which will be lying in this position here, and then go underneath themuscle so we've got good coverage of the implant in the upper part here where our patient isrelatively slim, so we get good coverage of the muscle there. so what i've done therenow is i've gone under the muscle. this is the muscle layer here, so we're underneaththe muscle to give that extra layer coverage here and i've [inaudible 0:54] the way around.so now we're just going to put the sizing implant in, which i'll show you in just aminute. now i'm going to put
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