Plastic Surgery Breast surgery Consultation

RE: Emily Parker - Aug - LN/ML  
DOB: 

Thank you for referring Emily Parker - Aug - LN/ML to our plastic surgery practice for consultation. I had the pleasure of evaluating her on January 13, 2026.

CHIEF COMPLAINT:
Emily Parker - Aug - LN/ML presented with concerns regarding breast augmentation and revision of previous breast surgery.

HISTORY OF PRESENT ILLNESS:
Emily Parker - Aug - LN/ML is a 25-year-old female who reports dissatisfaction with breast asymmetry and scarring following previous breast surgeries. She is interested in breast augmentation with a smaller implant and areola revision for improved aesthetics. She previously underwent breast augmentation in 2018 with Dr. Carter, followed by explant and reconstruction in 2019 due to tubular breast deformity and aesthetic concerns. She is dissatisfied with jagged scarring around the areola and asymmetry, noting the right areola sits higher than the left. She prefers a smaller implant size (200-225 cc) for subtle enhancement. She denies sensation issues post-surgery and has no concerns with the vertical scar down the breast. She inquires about the impact of surgeries on future breastfeeding and understands the risks, including capsular contracture and nipple-areola complex tissue compromise.

PAST MEDICAL HISTORY
- Medical Conditions: None reported
- Surgical History: Breast augmentation (2018, Dr. Carter), explant and reconstruction (2019)
- Medications: None
- Allergies: None
- Social History: Non-smoker, no history of asthma, no issues with general anesthesia

PHYSICAL EXAMINATION
Breast Examination:
- General appearance: Breasts are symmetrical and appropriately sized
- Skin quality: Overlying skin is intact, no visible abnormalities, erythema, or edema
- Breast tissue: Generally soft consistency with a slight area of firmness, possibly scar tissue
- Nipple-areolar complex: Jagged scarring around the areola, right areola sits higher than the left
- Palpation findings: No signs of infection

ASSESSMENT:
1. History of tubular breast deformity, previous augmentation, explant, and reconstruction
2. Significant breast scar tissue from multiple prior surgeries
3. Breast asymmetry and areolar scarring

PLAN:
1. Recommended Procedure
- In-person visit to determine appropriate implant size, likely within 150-225 cc, considering her petite frame
- Implant sizing to be finalized during this appointment
- Areola revision to be considered as a staged procedure after augmentation and healing
2. Timing
- Sizing appointment to be scheduled; surgical timing to be determined based on sizing and patient decision
3. Pre-operative Requirements
- None specified at this time
4. Post-operative Care
- Patient advised to remain in xxx xxx for the first night following augmentation
- Scar care kit and microneedling for scar healing discussed

DISCUSSION:
- Implant considerations: Patient educated on implant-related risks, including capsular contracture, asymmetry, and potential future surgeries
- Realistic expectations: Discussed likelihood of achieving subtle enhancement with a smaller implant, potential for persistent asymmetry, and the need for staged areola revision
- Specific risks: Capsular contracture, malposition, changes in sensation, scarring patterns, need for revision, impact on future breastfeeding, nipple-areola complex tissue compromise
- Long-term considerations: Implant longevity, need for future replacement, impact of additional surgeries
- Alternative options: Fat grafting discussed but patient not interested; non-surgical options reviewed

Emily Parker - Aug - LN/ML appears to have a good understanding of the information provided and has had all questions answered to her satisfaction. She will return for an in-person sizing appointment before finalizing her decision regarding implant placement.

Thank you again for the opportunity to participate in Emily Parker - Aug - LN/ML's care. If you require any additional information or have any questions, please don't hesitate to contact me directly.