1. How do I choose breast implant size?
This is the most confusing question for breast augmentations, yet can be answered simply. I choose breast implants based on an objective assessment of the upper body, breast, and breast tissue. This allows me to avoid arbitrary decisions, such as bra cup size or strictly the implant volume. For any given patient there is an optimal estimated implant fill volume and shape for that person’s individual breasts. It can be accurately predicted by standard measurements. This information is used in conjunction with the patient’s preferences to determine the final implant choice.
I often hear my patients say their friend or another patient or someone on the internet was the same height and weight and used a certain size implant. The important distinction is women of the same height and weight may have drastically different breast dimensions and breast tissue characteristics. There are many factors involved beyond what you see.
Published information using these diligent concepts has demonstrated lower re-operations and less complications. Thus, it is my preference to use these concepts to provide my patients with a much more accurate assessment of breast implant size than previously possible.
2. What cup size will I be?
Not a day goes by where one of my patients doesn’t ask me what cup size they will be after their breast augmentation. Since the inception of bra cup sizing, this terminology has been accepted and used freely by women and retailers all over the world. However, numerous problems exist with predicting bra cup sizes for breast augmentations. In fact, for several reasons, it is not possible to do this.
First, bra cup size has no universally accepted definition, therefore, it is a disservice to tell patients that they will be a specific cup size after surgery. The reality is that we cannot guarantee any cup size.
Second, as most patients are aware, a “C” cup bra from Victoria’s Secret is different than a Calvin Klein “C” cup…which is different from a Nordstrom’s “C” cup… In fact, there is no standardization in bra cup sizing throughout the whole bra industry. This is important for all potential patients to understand.
Lastly, many problems that stem from initial inappropriate breast implant sizing, was a result from attempting to achieve unrealistic patient goals or physician goals with the breast augmentation. In other words, I think it is important to begin a consultation discussing what the patient’s current bra cup size is and what bra cup size she would like to be; however, given the above factors, all informed patients must understand that ultimately no bra cup size can be guaranteed.
At our office, the most important thing we do in every consultation, is aim to match the implant selection to the unique dimensions and tissue quality of that individual patient. For any given patient, there is a certain limit of how large that patient can go without producing a myriad of potential irreversible deformities over time, as previously described on our website.
Based on my conversation with the potential patient and a careful objective analysis of that patient’s dimensions and soft tissues of the breast, we can make a fairly accurate prediction of how close to the stated desired cup size we will get post-breast augmentation.
It is imperative for all patients to understand the issues surrounding the focus of bra cup sizes, and even more imperative to understand that we can only produce a breast size that is appropriate for that individual patient… if we want to avoid the negative trade offs or long-term issues that result when this concept is disregarded.
3. Reoperation rates have been 20% for the past 15-20 years in breast augmentation. Is this still currently true?
Yes. In fact, a 20% reoperation rate has been commonplace in every FDA PMA study submitted over the past 15 years; however, better results and lower reoperation rates ARE possible. This is accomplished through proper patient education and objective implant selection using appropriate clinical analysis, meticulous surgical technique, and detailed postoperative instructions. There are several peer-reviewed, published studies and presentations that have been done in the past five years, that demonstrate an improvement of reoperation rates, lowering them drastically to 1 – 3%. In my professional opinion, these low percentages represent a new era for this procedure. My goal for every patient undergoing a breast augmentation is to enhance the overall experience and to minimize the rate of reoperations significantly. I recently published a six-year experiment, reporting a 2.8% reoperation rate for my primary breast augmentation patients. This 2.8% outcome proves that the goal of a consistent low reopertation rate is attainable.
4. Will I have a lot of pain following my breast augmentation?
A unique rapid recovery is one of the important benefits that we offer our patients undergoing breast augmentations. In general, recovery after a breast augmentation has been characterized by intense pain, immobility, drains, straps, lying in bed for 1-2 weeks; what could be summed up as a fairly overall negative early experience.
Recent advances in breast augmentation has allowed us to completely revolutionize the patient experience. I tell my breast augmentation patients there is a 98% chance they will resume normal activities of daily living within 24 hours of the procedure.
I am confident that any patient of mine undergoing breast augmentation will be able to go out to dinner the night of the procedure and feel very comfortable doing so. I often marvel at my patients’ comments after they return for their follow-up visits that their recovery was incredibly easy and so very different from many of their friends who have previously undergone these procedures. Patients are encouraged to get moving right away and may return to work and usually drive themselves in 1-2 days.
I truly believe this is a great advancement for all breast augmentation patients and I know it is one of the most special benefits that we offer patients in our office.
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