The Plastic Surgery Channel

Here’s a Plastic Surgery Secret: Don’t Think Bigger is Always Better

Bonus size. King-size. Colossal. Jumbo. Giant. Extra. No matter where you turn – restaurants, clothing stores, hardware big box stores – everyone seems to be offering us more for our money. In other words, “Bigger is better.”

Is the same true when it comes to breast augmentation and plastic surgery?

The Best Way to Know the Right Implant Size? Study!

Deciding whether to go bigger or smaller no longer needs to be a leap of faith. Today’s imaging technology allows patients to view their possible breast augmentation before they set foot in the operating room, utilizing measurements and photographs to construct 3D images. For most patients the simulations are very accurate – upwards of 98% accuate – and help to find the implant that works best for them.

With all of the choices in shapes and fills, there is no one, “right implant.” Instead, there is often a small range of implants that will work well, depending on a patient’s goals. More information and more options are available to give patients the knowledge and control needed to make the best personal decision.

Safety is primary, but then what?

“How big?” is far and away the most asked question by breast augmentation patients says Patricia McGuire, MD, a board certified plastic surgeon in St. Louis. “After safety, the most common questions and concerns that I hear from my patients who are considering breast augmentation is ‘What amount of volume should I have?'” Dr. McGuire shares. “And what size will her breasts be after the procedure? What I prefer to do is a more anatomic approach using measurements on a patient.”

Dr. McGuire is not a big fan of guesswork and hunches when discussing how large (or small) possible augmentations should be. And especially when larger implants are up for discussion, she’s certainly not in favor of shooting from the hip.

Four Considerations from Dr. McGuire

“Four things that I utilize: What is the patients breast width? Usually there’s a couple implants that will fit comfortably within that space, usually four or five,” McGuire explains. “The next measurement is the height of the breast. The patient may have a very long chest and may need a taller implant. If I’m using a shaped device or if she has a shorter chest, it might be best to use a device that’s not as tall.

“The third consideration is what’s the patient’s tissue type? Is her skin loose or is it tight? A looser breast may require a little more volume to fill that. But, if the tissues are weak or thin, too much volume could cause the breasts to sag. So we have to take that into consideration as well. And the fourth consideration is ‘What does the patient want?’ Does she want something too big or not big enough?”

Whatever size, Patients need to be Patient – and Informed!

Dan Del Vecchio, MD, a board certified plastic surgeon practicing in Boston, says he and has colleagues were taught that they should not augment a woman’s breasts with implants that exceed the size of the soft tissue around the breast.

“There are women out there who go to their plastic surgeon and request implants that are way beyond the soft tissue envelope,” Del Vecchio tells The Plastic Surgery Channel. “So the ethical and surgical question is do you give the patient an implant that is beyond the soft tissue envelope, or not? And if you do, what do you need to tell her of the consequences of that? And I think this is an issue that is very grey.”

Ultimately, the wishes of the patient will decide how big or small a breast augmentation will be. The key for patients is to find a surgeon who will listen and also provide guidance – whether that’s in the form of knowledge regarding the latest implant offerings, 3D imaging, or the analysis of your chest measurements and tissue quality. The best breast surgeons do not make decisions for their patients. They offer up all pertinent information objectively and via an in-depth conversation with their patient, decide on what would best meet the desired goals.