Richard V. Dowden, M.D., C.M., F.A.C.S.

Certified by the American Board of Plastic Surgery

Cosmetic and Plastic Surgery, Inc.
6770 Mayfield Road, Suite 410
Mayfield Heights, Ohio 44124
(440) 449-7470


Breast Enlargement/Augmentation with Breast Implants

Before-and-After Photos


WARNING: FOR ADULTS ONLY

There is no pornography on this site.

However, this page does include informative photographs of unclothed female torsos and breasts, presented in a straight-forward and non-offensive manner with an educational intent. In most states, persons under 18 years of age are prohibited from viewing these photographs. Furthermore, in some countries, all persons are prohibited from such viewing. And, there are some people everywhere who find such photographs offensive for various personal reasons. If you fall into any of these categories, you are hereby warned, and you are instructed to leave this site now by clicking the Back button on your browser. If you are under the age of 18 years, or if you are offended by such materials, or if you live in an area where viewing such photographs constitute a violation of any law, regulation, rule or custom, or if you are acting on behalf of any governmental agency, you are not authorized to view or download any materials and all such viewing or downloading shall constitute intentional infringement of the rights of the site operator.

You may wish to read the following while waiting for these photos to load.

What is asymmetry?
It has been said that only one woman in a thousand has symmetrical breasts, while the other 999 have asymmetry. The women whose photos appear on these asymmetry pages are examples of the 999 whose breasts are not symmetrical. Breasts can be asymmetrical in many different ways:

How well can asymmetry be corrected?
The amount of correction of breast asymmetry that can be accomplished by augmentation depends upon the number of the asymmetrical features and their degree of severity. Minor asymmetry can be compensated for rather well. Severe asymmetry cannot be corrected without leaving considerable external scarring. The more features that are asymmetrical, and the greater the degree of those asymmetries, the less correction can be achieved by breast augmentation.

As is apparent from the photos, many women whose breasts and nipples are not symmetrical also have other physical discrepancies:

Nipple-areola positions unequal:
This is the most frequent inequality, and it is a rare woman whose nipples are symmetrically positioned. No matter what the nature of the asymmetry, there is no known breast augmentation technique that can move the nipples without an incision, which leaves a scar around the areola. As you will see from the photos, sometimes adjusting the breast volume and contours can help disguise the pre-existing asymmetry of nipple position, but in reality the nipple and areola cannot be relocated on the skin without the incision around the areola. None of the women on this page had their nipple-areola repositioned. From these photos it is apparent that enlarging the breast not only enlarges the areola, but it also magnifies the asymmetry, making pre-existing differences more noticeable afterwards. Even very small differences will become magnified. In the more dramatic cases of breast asymmetry, where one breast has simply not developed as much as the other, the nipple-areola on the less developed side will be much smaller and higher than the other breast. Even after augmentation, those differences in nipple-areolar position and size will remain. Those with nipples positioned unevenly in a lateral direction are noteworthy also: if the nipples are widely spaced on the chest before operation, they will remain widely spaced afterwards; if they are close together before, they will be close together afterwards. If one nipple is excessively too far to the side before, it will remain so after.

Different breast volumes:
Differences in breast size can usually be adjusted, by using slightly different volumes of saline fill in the two implants. However, there is a strong limitation to the ability to equalize the sizes: as explained elsewhere, each implant has a narrow range of optimal fill volume, and going outside that range will likely decrease the durability of the implant and shorten its longevity. Unfortunately, these ranges are not contiguous, the result being that some volumes cannot be realized. That in turn means that we are limited in our ability to equalize the unequal breast sizes, and very often have to accept some remaining size difference in order to avoid decreasing the durability of the implants.

Asymmetrical breast position:
Some women with unusually high breasts request that the implants be placed in a lower position to make the wearing of clothes easier for them. A drawback of doing so is that the nipples, which are not moved down, then look a little high. Examples can be seen on these pages, and those women who requested a major adjustment of breast position were well aware that the nipples would appear to be displaced.

Under-breast crease imbalance:
Differences in the position of the under-breast crease can be corrected reasonably well by breast augmentation. In contrast, differences in the shape of the under-breast crease are much more resistant to correction, particularly if one crease is quite sharply defined while the other is not very defined at all.

Shape differences:
Differences in shape can be corrected to a limited degree by breast augmentation. The amount of correction depends upon the extent of the problem. The more severe the shape difference, the less well it can be corrected.

An important reminder about upper pole definition:
As explained elsewhere on this website, the amount of upper-breast definition is specifically chosen by each woman. That is, each woman decides how sharply defined she would like her upper breast curve to be, i.e. how much of the very round look she desires. Each woman is informed ahead of time how much upper definition she is likely to achieve depending upon her anatomy and the following factors:

Because people do not have standardized tastes and preferences, the women seen on these pages may have less upper breast definition than you yourself would prefer, or may have more definition than you would like to see on yourself. Some women asked for the highly defined look, and others for the smoothly sloping look. In all of the patients shown here, the amount of upper breast definition was specifically chosen in advance by the woman herself.

About these photos

First and foremost, all of these women have given permission for their photographs to be published. No faces are shown, and the photographs are in strictly medical format.

For each patient, the before photo is above, the after is below. Below each before-and-after set is listed these data about that patient: For example: 12345 Axilla Under R280 L290 means:

The photos



06917 Navel Over R390 L390





19683 Axilla Under R315 L315





22325 Crease Under R240 L240





23949 Navel Over R450 L450





30415 Navel Under R570 L570





30651 Navel Over R390 L390





32784 Navel Over R355 L330





34053 Navel Over R450 L450





35059 Navel Under R380 L390





35465 Navel Under R330 L330





35774 Navel Under R390 L375





36005 Navel Over R390 L390





36194 Navel Under R430 L420





36704 Navel Under R570 L550





36770 Navel Under R430 L440





36788 Navel Over R380 L390





36851 Navel Under R450 L420





36932 Navel Over R550 L570





37441 Navel Over R570 L560





37598 Navel Under R510 L480





37750 Axilla Under R360 L360





39029 Navel Over R600 L600





40280 Areola Over R550 L550





41252 Navel Over R325 L300





41715 Navel Over R265 L245





41846 Navel Under R335 L350





41985 Navel Over R290 L280





43440 Navel Over R330 L310





43880 Navel Over R390 L380





44072 Navel Over R570 L530





44519 Navel Over R330 L350




An important cautionary instruction:
Each woman is a unique individual, and her decisions and her operation are unique to her. These photographs can be helpful for getting an idea as to what has been accomplished for other women. These photos must not be viewed as if this were a catalog from which to choose the details of ones implants and operation. A woman should not make any decisions about her own implant size, shape, incision, or muscle plane based upon these photographs. Only a consultation between the woman and her plastic surgeon can permit finalization of these important decisions.

No need to seek confirmation of the data:
Because the viewer is unable to discern the patients build, height, weight, frame etc, some patients may appear to have larger or smaller implants than they actually do. There is no need to point out to us that the appearance of any of these patients does not seem to be consistent with the data listed about her. The data are correct.

Please note that the information displayed is the only information that will be made available about these patients. As it turns out, additional information such as the patient age, height, weight, her bra size, the implant manufacturer and implant style, are actually less helpful to patients than one might expect. For that reason, any requests for such information will have to be declined.

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This page and images are Copyright Richard V. Dowden, MD © 2000, 2001, 2002, 2003, 2004, 2005,
2006, 2007, 2008, 2009, 2010, 2011.
These photos may not be reproduced or distributed electronically or in print.

Note that while the information given by Dr. Dowden during a consultation is completely current and up-to-date, the information on this website is only as current as the last update, and therefore may become somewhat out-of-date.

Cosmetic and Plastic Surgery
6770 Mayfield Road, Suite 410
Mayfield Heights, Ohio 44124
(440) 449-7470

Last Update: 21:37 on 06/07/2011

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