Breast augmentation and cleavage enhancement. Can these two cosmetic goals be achieved, or should the patient accept some compromises and limitations?
Leading Beverly Hills plastic surgeon Dr. Tarick Smiley has recently posted photos on Snapchat demonstrating a patient with bony indentations and wider gap between her small breasts.
To “hide the bony indentations and create a “very soft and natural cleavage,” Dr. Smiley said he used a slightly wider breast implant to “fill in the gap and visible dents.” Nonetheless, he made sure that the horizontal measurement of the implant would still “reflect” the patient’s pre-existing soft tissue coverage to prevent rippling and increased palpability.
“A lot of followers asked if I used fat grafting or injecting to hide the bony indentations. I did not. The right implant design is enough to deliver good results for this patient,” he said.
The patient shown in the picture also received a conservatively sized implant, 400 cc, further reducing the risk of rippling, scalloping, and palpability, problems that plagued overlarge breast implants.
The implants were propelled into their pocket through a peri-areolar incision, meaning a small U-shaped scar was positioned at the lower border of the areola. At three months, it is almost undetectable thanks to meticulous wound closure technique in which no tension was put on the skin.
“That’s why you should always respect the skin. The scar is just three months old and is already unnoticeable. It will continue improving up to 18 months,” Dr. Smiley said.
The patient has been deemed a good candidate for the said incision technique because of the stark color contrast between her areola and the surrounding “normal” skin, making it easier to hide the scar.
Dr. Smiley said he follows a “nine point system of breast perfection” to achieve natural and proportionate-looking breasts.
“The nipple should be right in the middle of the breast, at the most projected part, and should lie at least 2 cm above the inframammary crease. Most of the volume should go to the bottom or lower breast pole, while the upper pole should receive a moderate degree of fullness. The lateral bulge, meanwhile, should not account for more than 10 percent of the total volume,” he explained.