The Surgeon Minute

Breast Implant Decisions – A Breakdown

Breast Implant Decisions – A Breakdown

The decision to have a breast augmentation is only the first in a long line of decisions on the road to bigger breasts. If you thought you could order up a new cup size and move forward with surgery, think again! There is much more nuance and important choices to be made beyond just a general cup size. You will need to choose a surgeon, a type and size of implant and then decide on implant placement and incision placement.

Measure Twice, Cut Once

The proverb refers to carpentry, but the same adage applies to plastic surgery. The time you invest in careful planning and decision making with your surgeon prior to surgery will help prevent the need for a second operation to change the size. Board certified plastic surgeon Dr. Sean Doherty agrees. In fact, he believes the time spent planning before surgery is just as important as the time spent in the operating room on the day of surgery.

In his Boston practice, Dr. Doherty divides the breast augmentation planning process into multiple visits. The first visit is important for establishing a relationship and open communication between the surgeon and patient. “You want to make sure you have the same aesthetic as your surgeon. You want to make sure that that surgeon is listening to you and understands what you are looking for,” says Doherty. “I like to meet patients first, so they understand me. If we decide we get along and they want to work with me, I like when they come back in and I can do a sizing with them.”

Think Outside the Cup

Cup sizes are not standardized. They often vary from store to store and brand to brand. An A cup at Victoria’s Secret may be very different from an A Cup found in a department store.  

“Oftentimes I have patients come in and say, ‘I want to be a full C or a D,’ and I let them know that there is a lot to a breast augmentation, and for me to actually guarantee a cup size is not the right thing,” says Doherty. Instead of aiming for a cup size, he uses the patient’s anatomy to determine the best implant for achieving their goals.

If a surgeon promises to deliver a specific cup size, it can be a red flag, says Doherty. “You want to feel confident that a surgeon is actually going to tell you what you can and can’t have,” he adds, “If someone just agrees to give you a double D, I would keep looking for another surgeon.”

Useful Tools for Breast Augmentation Planning:

  • Pictures from magazines & the Internet
  • Before & after pictures of other patients
  • A spouse or significant other
  • Mirror

A Picture is Worth a Thousand Words

What one woman considers a really full breast may be more of a natural-looking breast in the mind of another woman. When it comes to understanding the look you are after, pictures of breasts in magazines or online that you admire can be a useful tool. When you see a look you love, grab your scissors or hit the print button, and bring the pictures with to your consultation.

“It’s nice to see what their aesthetic is,” Doherty explains. “I like to see what they like and then what they don’t like. I often remind them that they are showing me pictures of a very stylized person – whether it’s a celebrity or a model, and I’m not going to create that – but it really gives me an idea of do they like a really full breast or do they like a really subtle breast, so it’s extremely helpful.”

Breast Asymmetry is Reality

A photograph of a plunging neckline in a magazine does not bring to light the reality that no two breasts are identical. It’s important to recognize existing asymmetries prior to surgery. During the consultation, Dr. Doherty measures the breasts, pointing out in a mirror where the asymmetries exist. “Women have asymmetry that will stay even after the most beautiful breast augmentation,” says Dr. Doherty. “That stays, and that really needs to be discussed.”

Breast implant - before and after.

Significant Others and the Breast Implant Planning Process

Your surgeon will guide you toward the best options for your anatomy, but it can also be extremely helpful having someone who loves you and knows you well at your side during the decision making process. They can offer advice and feedback and serve as an extra set of ears to remember all of the important details. “I like to have their husband, or boyfriend or partner come with for the sizing,” says Doherty. “It’s a big decision. Talking about it all before surgery is really the safest, best way to go.”

A Happy Patient is an Involved Patient

“The happiest patient is the one who makes all the decisions with me beforehand,” shares Doherty. “Nothing is scary, nothing is left up to decision at the time of surgery. That is the absolute happiest, most satisfied patient.”

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