Most women who seek breast augmentations come to their plastic surgeons with fairly routine requests. They either want to undergo size enlargement or want to change what was previously performed. Their anatomy is mostly symmetric and if it’s a revisionary procedure, they know what was implanted. Sometimes, that is not the case.
Breast augmentation is considered complex when the history or anatomy requires a creative combination of techniques to create a good result. The reasons for these asymmetries differ. They can be developmental. They can be secondary to childhood surgery. They can be due to prior breast surgeries, either reconstructive or esthetic. The most important determinant of success is being able to figure out what happened and why it happened. Prior surgery often complicates our efforts since the normal anatomy is altered. We are not certain from where the blood supply or nerves reach the nipple. Familiarity with various techniques, including those currently out of vogue, is imperative.
Once we establish the problem, we need to know the patient’s goals. It’s not about the surgeon’s special skills; it’s about what the patient wants. If the patient’s goals are unrealistic, the goals need to be discussed and perhaps modified.
Implants come in different sizes. Implants come in different profiles. Implants come in different shapes. Implants are made of different materials. Implants can be placed in different pockets. Effectively, we have to reorient our thinking to come up with a good solution to make pleasing and symmetric results.
Breast augmentations can also be helped by the use of mastopexy. There are a lot of ways to shape the breast and we have to make use of those various techniques. Fat transfer can often be the best way to contour breasts outside of the limits of the implant. Liposuction can also be used to contour the margins of the breast to make a pleasing result.
Complex breast augmentations are a category of breast augmentation that reflects outside-the-box thinking. We not only have to consider how to do things right, but we also have to appreciate how it can all go wrong. With Dr. Geldner’s superior skill, 25 years of experience, and his experienced and compassionate staff, we exceed our patient’s expectations.
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“’Thank you’ feels so little compared to the emotions I have inside. You are not only an artist and doctor, you are a humanitarian. I never thought I would look normal again. I cannot believe how beautiful the results are. Thank you for your patience, you perfectionism and most of all for caring.”