Bobbi Althoff, 29, says she is getting implants in January. Six years of nursing two daughters, with overlap. She thought about a lift, passed, because more kids are likely. And she wants “a little bit of a sag.” People had it October 29, via Yahoo; The Blast added a hair transplant the next day.
No surgeon named. I have not examined her. So, no diagnosis. Just the plan, which I hear every week.
A Little Sag, in My Words
More of my patients ask for less:
“I have an increased number of patients looking for slight changes using implants under three hundred CCs, and even using the Motiva Preserve procedure for a much faster recovery.”
What they mean:
“The patient that comes in looking for the ballerina look is usually asking for a subtle augmentation with an upper pole slope, without too much upper pole fullness, and an overall natural, not done look. This is usually a look that is achievable with a patient that is not very large breasted to start with.”
The implant that does it:
“It’s ergonomic, which means the implant actually moves with you. So this implant is a gummy bear, but it’s round when you lay down, and when you stand up, it kind of turns into a teardrop. So it’s more natural. It’s pretty soft.”
And where it goes:
“When implants are under the muscle, the muscle is always pushing them to the sides, so eventually they move to the sides, and whenever you lift or contract the muscle, it looks less natural.”
“Those older patients I showed you were under the muscle because Motiva wasn’t available yet. Before Motiva, we put everything under the muscle.”
“When you see them move and contract during exercise, that means they’re under the muscle. Over the muscle, you don’t see that.”
Skipping the Lift
The rule I use:
“If the nipple areola complex is below the inframammary fold, then a full lift, anchor type incision, will be necessary. If the nipple areola complex is at or slightly above the inframammary fold, I will often recommend a circumareolar lift or donut lift.”
“If the lift is not performed during the augmentation and there is considerable sagging, then the implants will appear to be higher up, even though they are in the right place, and the nipple areola and breast tissue will hang over it.”
A mom of three, nursed for years, measured at 23:
“The nipples are a little bit low. With the implant, it does lift up a little bit, without having to do any lift per se.”
“You can see it gives you the volume where you’ve lost it, which is the upper part. Gives you more projection. It lifts it up a little bit. From the top, you get a nice cleavage, but it’s still, we call it ballerina breast, because it’s not obvious that there’s an implant there.”
And when a lift is done anyway:
“As you can see, when we do the doughnut lift, it still has kind of a natural slope to it. But it’s considerably perkier than before.”
“A breast lift will always give a perkier look, more upper fullness, and cleavage, but it’s going to have usually a natural slope on top.”
Sag, either way. Just planned.
More Kids First
Her reasoning holds. My version:
“Patient who wants augmentation before she is done having kids: go ahead. There are still going to be changes in the breast with or without implants. Surgery may be necessary after pregnancy even without implants, for a more cosmetic and aesthetic look.”
On nursing, I promise nothing:
“Either way, there is a risk that you will not be able to breastfeed, but that risk also exists even if we do nothing, because we do not know.”
With Preserve:
“These implants are going over the muscle. I’m not doing any cutting. So the pocket is made just by moving everything to the sides. That’s why it’s called Preserve, because we’re preserving all the arteries, all the nerves, all your ducts, and we’re preserving your ligaments so that the implant’s actually inside the ligament.”
“Well, because we’re not cutting anything, everything you were born with will be the same. There’s a higher likelihood that you’ll be able to breastfeed and not have any issues with it. And sensation as well.”
“So the recovery is ultra fast. You’re back to work the next day, you can go back to the gym in two weeks.”
What the Video Leaves Out
Same thing a review leaves out:
“What a first-person review usually leaves out is that the writer’s result started with the writer’s anatomy. A thin, athletic patient with good nipple position and a little breast tissue will get the ballerina look with a small implant or fat transfer alone. A patient with more sagging, a wider chest, or a longer sternal notch to nipple distance will need a lift or a different implant to get anywhere close, and the review will not tell you that.”
“One of the advantages in my practice is that we can simulate the results using the Vectra 3D system and the Crisalix system to visualize the results even before the surgery.”
The hair transplant? “A transplant moves hair; it does not make new hair.”
Full surgical version on Agullo Plastic Surgery, with the Motiva Preserve technique. Consult-room version on Southwest Plastic Surgery. Two more celebrity moms: Cardi B and Jennifer Lawrence.
Why Choose Dr. Agullo
Double board-certified by the American Board of Plastic Surgery and the American Board of Surgery, Mayo Clinic plastic surgery fellowship, Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center, and a Castle Connolly Top Doctor for 13 consecutive years. Trained in Motiva Preserve by Motiva in Costa Rica as one of about 30 selected US surgeons.
Ready to Talk?
Get measured. Then decide. (915) 590-7900, text 1-866-814-0038, or book at agulloplasticsurgery.com/appointments. #StayBeautiful
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