1. How do I choose breast implant size?
This is the most confusing question in breast augmentation, yet can be answered very simply. I choose breast implant size based on objective assessment of your breast and breast tissues. This allows me to avoid arbitrary decisions such as cup size or volume of implant. For any given patient there is an optimal estimated fill volume for that patient’s individual breast, and this can be accurately predicted by objective measurements. This information is used in conjunction with any specific patient requests to determine the implant size.
I often hear my patients say their friend or another patient on the internet was the same height and weight and used a certain size implant. The important distinction is women of same height and weight may have drastically different breast dimensions and breast tissue characteristics.
The published information using these concepts has demonstrated lower re-operations, and less complications. Thus it is my preference to use these concepts providing 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 does not ask me what cup size they will be after breast augmentation. Since the inception of bra cup sizing, this terminology has been accepted and used freely by women all over the world. However, several problems exist with predicting bra cup size post breast augmentation and, in fact, it is not possible to do this for several reasons.
First, bra cup size has no universally accepted definition and, therefore, it is a disservice to tell patients that they will be a specific cup size when, in fact, the reality is that we cannot guarantee any cup size.
Second, as all of my patients are aware, that a “C” cup bra from Victoria’s Secret is different than a Calvin Klein’s “C” cup, which is different from a Nordstrom’s “C” cup. In fact, there is absolutely no standardization in bra cup size throughout industry. This is important for potential patients to understand.
Lastly, many of the problems that have been caused by inappropriate breast implant sizing where the result of trying to achieve unrealistic patient goals or physician goals with 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.
The most important thing we can do during the consultation is to try to match the implant to the dimensions and tissue quality of that individual patient. That is what we strive to do in every consultation. For any given patient, there will certainly be a limit of how large that patient can go without producing many of the potential uncorrectable deformities that have been described on this website.
Based on my conversation with the potential patient and a careful objective analysis of that patient’s breast 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 very important for all patients to understand the issues around bra cup size and even more importantly to understand that we can only produce a breast size that is appropriate for that individual patient if we want to avoid many of the negative tradeoffs 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, 20% reoperation rates have been commonplace in every FDA PMA study submitted over the past 15 years; however, better results and lower reoperation rates are clearly possible. With proper patient education objective implant selection using appropriate clinical analysis, meticulous surgical technique and detailed postoperative instructions. There have been several peer-reviewed, published studies and presentations in the past five years, which demonstrate the reoperation rates between 1 and 3% are clearly possible and, in my opinion, represent a new era in this procedure. My goal for every patient undergoing breast augmentation is to enhance the overall experience and to minimize the reoperation rate. These goals are clearly attainable, and we have just recently published our six-year experience, including a 2.8% reoperation rate for primary breast augmentation patients.
4. Will I have a lot of pain following my breast augmentation?
A rapid recovery is one of the important goals and benefits that we offer our patients undergoing breast augmentation. In general, recovery after breast augmentation has been characterized by a lot of intense pain, immobility, drains, straps, lying in bed for 1-2 weeks with what could be summed up with a fairly negative overall early experience.
Recent advances in breast augmentation have allowed us to completely revolutionize the patient experience for breast augmentation. What I tell my breast augmentation patients is I would expect them to have a 98% chance for a recovery back to the normal activities of daily living within 24 hours of the procedure.
I fully expect any patient of mine undergoing breast augmentation will be able to go out to dinner the night of the procedure and feel very comfortable and good 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 may return to work usually in 1-2 days.
I truly believe this is a great advance for all breast augmentation patients and think it is one of the most important benefits that we offer our patients today.
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