Breast Augmentation with Nipple Reduction in Raleigh, North Carolina*

This 51-year-old woman has lost volume after childbirth many years ago and decided to make improvements through breast augmentation. She wished to go from an A cup to C cup. She had done research on silicone gel implants and because of her small volume decided on silicone gel implants. 3D imaging done preoperatively helped in her decision in choosing an implant size. Dr. Lyle uses the Crisilix system which helps to arrive at an appropriate size range. She also had very long and large nipples and wished to have them reduced. Patients with large nipples frequently complain that they even are more prominent after augmentation and certainly this can be accomplished during the augmentation. This patient underwent bilateral submuscular placement of Sientra moderate plus 355 cc smooth walled silicone breast implants. This company was the first to offer a 20-year warranty and also a capsular contracture warranty. Dr. Lyle places the implants with a Keller funnel which can reduce potential damage to the implant and also is felt to help reduce capsular contracture by limiting the exposure to the skin which does contain low amounts of bacteria even after antiseptic prep. Nipple reduction is done after the closure of the breast to reduce infection risk as the nipple ducts do harbor bacteria. There are several nipple reduction techniques this case, removal of a doughnut of skin at the base of the nipple was performed to help reduce the nipple length -maintaining sensation.