Breast Implant Surgery (Augmentation Mammoplasty)

In Dr. Mondolfi’s opinion, the goal of breast enhancement surgery is to create breasts that look as natural as possible and proportional in size and shape to your body frame.

This is most commonly achieved by the use of breast prostheses, and in very selected patients by the grafting of the person’s own fat.

He will hear your concerns and gauge your expectations. Then, after evaluating your body shape and performing a comprehensive examination of your breasts, chest wall, musculature, and skin, he will propose the method of breast enhancement he feels best suited in your case.

If a prosthetic enhancement is indicated, you will jointly discuss the many available breast prosthesis. He will explain why, in your case, the devices should be placed in front of or behind the pectoral muscles and lastly explain advantages and disadvantages of sub-mammary, areolar, axillary or umbilical incisions. Then, and only then, you may jointly make the final decision.

For information regarding breast implant safety go to: www.breastimplantsafety.org

Typically, patients who seek breast enhancement surgery will present one of the following three problems:

• Small, underdeveloped breasts with little or no drooping.
• Breasts that have lost volume and consequently have some degree of drooping.
• Breasts that have deflated and developed significant or exaggerated drooping.
• Or breasts that have an unusual shape or position, are very asymmetrical or exhibit variations in the shape of the chest wall.

Breast Augmentation,
No Ptosis (sagging)

These are patients who have scarce breast tissue, or patients who have lost breast volume following pregnancy but who have good skin tone and the nipple/areola complexes show minimal descent. Patients in this category may be candidates for Silicone Gel filled devices, the implants may be placed in front of or behind the muscle and may elect to use infra-mammary incisions (in the breast fold), axillary incisions or incisions below the areola. A very small and selected group of patients, may choose to have a very subtle enhancement using autologous fat grafts (using their own body fat for moderate increase in the fullness of the breasts).

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Breast Augmentation,
Slight Ptosis

The second group is characterized by patients who have small to average volume of breast tissue, and who after pregnancies or weight loss have seen their breasts shrink and become ptotic (saggy).

Some of these patients may be satisfied by placing a slightly larger, silicone gel filled device behind the breast as to fill the void created by the excess skin and improve the appearance without the need of additional scars. One drawback, however, is that the breasts may appear larger and slightly rounded.

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Breast Augmentation + Lift,
Severe Ptosis

Those patients that have a combination of insufficient breast volume and more advanced drooping are not candidates for simply an augmentation. These cases are best managed by combining a breast lift with the insertion of a breast prostheses. The scars that this approach requires varies from a simple around-the-areola lift, but often a vertical incision needs to be added and lastly, if there is a lot of redundant skin an anchor-like scar might be needed.

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Breast Augmentation,
Other Issues

Lastly, there are those patients who present with under development of the breasts but have associated issues such as a disparity in the size and/or shape of the breasts, an unusual shape, breasts that lie too high on the chest wall or with misshapen rib cage.

View Before and After Photos