The patient presents with very severe breast asymmetry. Her breasts are different in size and shape. Notice the left breast is larger and lower. There is more skin laxity. It was decided she would undergo high profile saline implants with two different sizes with a 465 cc high profile placed on the left and a 425 cc high profile placed on the right. She underwent a bilateral formal mastopexy. Her postoperative results show that the cleavage is excellent, the inframammary folds are even and the nipple positions are quite symmetric. The volume of her breasts in a bra is now quite even. There is a little bit of flattening in the left upper pole, but this is due to her thoracic cavity preoperatively and cannot be corrected completely. The patient has maintained Bio Corneum twice a day for the last six weeks, regular underwire bra and a Dr. Linder bra at night for sleep.
Correcting breast asymmetry is significantly easier with saline implants because they can be filled to different amounts and the ability to correct is more apparent. Also notice her bra bulge greatly reduced, right greater than left, softening the right lateral breast tissue and the left bra bulge.
The patient is an Indian female status post delivery of two children. Good candidate for combined augmentation mammoplasty procedure using high profile saline implants and a left vertical mastopexy with full abdominoplasty. The patient is three months postoperative. She has had augmentation with dual plane technique, placement of saline implant high profile, under the muscle, 400 cc filled to 440 cc and a left lollipop Lejour breast lift in order to reposition the left nipple areolar complex. The implants will fall into a nice position and there is excellent symmetry.
The abdominoplasty shows well-healed scars. The umbilicus has healed well. No evidence of keloid and hypertrophic scarring on this Indian female patient. She also has lipo sculpting of the hips showing nice contouring of the sides.
This is an example of the augmentation mammoplasty with a left vertical breast lift and fully tummy tuck total body makeover on a patient with Indian descent without evidence of hyperpigmentation or scarring.
Dr. Linder’s procedure of the knob knee liposculpturing is the newest innovation with sculpturing of the medial knee fat pad, suctioning the fat along the medial knee area. He uses a small incision with a small 2 mm blunt tip cannula to 1 atmosphere of vacuum suction pressure to lipo-sculpt the medial knee area. This can be done under local IV sedation if done alone or it can be under general anesthesia combined with other areas, including the medial and lateral thighs, hips, and abdomen.
Medial knee liposuction requires finesse and very smooth liposculpturing of the localized deep fat deposits of the medial knee fat pad. This should be performed only by Board Certified Plastic and Reconstructive Surgeons who understand the anatomy of the difficult area.
The example shows a before and after of a patient one month postoperative from a medial knee procedure. The knob knee has been reduced by suctioning with a small cannula under tumescent technique. Notice a reduction of the fat herniation of the medial knee areas and a smoothing out of fat.
REQUIRING FULL BREAST LIFT
Four Weeks Post Op
The patient is an Armenian female presenting with severe weight loss which has caused her breasts to sag quite a bit. Not only a lot of loose skin, but the left breast is significantly wider and larger than the right. The patient is now post op four weeks after surgery, her sutures have all been removed, she has an excellent result, and the implants are now in the perfect position. The patient has been started on scar cream. Patients that have this much skin laxity and loss of breast volume should have both implants placed under the muscle (this patient happened to have a saline high profile implant placed under the muscle) and a full breast lift using the formal anchor scar called the Wise-pattern technique. She will continue with underwire bra, Dr. Linder Bra at night for sleep, and Bio corneum twice a day. These patients are excellent candidates for combination breast implants with lifts.