Age 23
2 children
Implants McGhan, round, textured, high profile, silicone gel, style 120
Size 340g
Under the muscle
Incision under the breast

Two difficulties to consider here. The patient has very little actual breast tissue just empty skin. Therefore she is at high risk of rippling. Saline should be avoided and the implant put under the muscle to minimise this risk. Also she has a very sharp and tight crease under her breasts. She is at risk of double folds where the original crease can be seen above the new crease formed by the bottom of the implant. The wider the implant chosen, the worse the risk of double folds. A small diameter implant (high profile and not too large) was used to reduce this risk. Nevertheless during the operation a double fold could be seen on the left breast. I therefore incised the band of tight tissue which was maintaining the old fold and this allowed it to disappear. This “infra-mammary fold release” is performed internally and so no extra scar is created. It can be done much more accurately through an incision under the breast and therefore I advise any patients at risk of a double fold to choose an incision under the breast.

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