Breast Augmentation in Tight Skin Envelope, Raleigh,NC*

This is a 22-year-old woman who had small, underdeveloped breasts- she wore an A cup. She desired C cup and wished to have silicone gel breast implants. She was fairly small framed and had very tight skin of the breast. She had not had any children yet. Placement of breast augmentation in tight skin envelope skin be challenging. Overly aggressive implant size can cause unnatural appearance. In most patients a submuscular augmentation is recommended because of thin skin covering which can lead to ripples even in gel implants and they can be more palpable. This patient underwent placement of submuscular 350 cc smooth-walled high profile silicone gel breast implants. A Keller funnel was utilized to reduce trauma to the implant and reduce chance of the implant touching the skin. Some believe this precaution may reduce capsular contracture. It took several months with the implants to become more natural appearing. In general, tight skin envelope does take longer for the final result to become apparent. In these individuals, Dr. Lyle often warns them that the implants will look fairly unnatural for up to several months until the skin stretches and the muscle relaxes. Limitations on size are discussed as over stretching of tissue can lead to implant malposition. This patient was very pleased with her now C cup brassiere and was much more confident wearing bathing suits and was able to change her entire wardrobe to suit her new body shape.