Much has changed in the last 25 years in the field of breast surgery. When implant options were once binary, today they come in a wide variety of shapes, sizes, textures and fill, allowing a plastic surgeon to customize breast augmentation in ways that were not available even a decade ago. Dr. Patricia McGuire of St. Louis, MO and Dr. Caroline Glicksman of Sea Girt, NJ have, between them, over 50 years of experience in breast surgery. They sat down with the Plastic Surgery Channel to discuss what they know now that they didn’t know then.
Breast Surgery Education = Successful Outcomes
Dr. McGuire has been in practice since 1991. During that time, the most important thing that she’s learned when it comes to breast surgery is “to listen to the patient” in order to figure out:
- Can I give her what she wants?
- Can I do it safely?
- Can I do it economically?
- Will the result last a long time?
I she can’t deliver on these points, then she needs to explain why to the patient and then see what compromises that patient is willing to make. Dr. Glicksman agrees. “I’ve learned to become a better educator, a better communicator.” She will spend an hour up front with the patient so that the procedure may only take 35 minutes in the OR because she knows exactly what, “we’re going to do”. There should be no surprises.
Patient education ensures that patients do not come out of surgery and say, “This isn’t the size that I thought I was going to be” or “I didn’t know that my nipples would point this way”. By taking the time to have a lengthy consult prior to surgery, the patient knows exactly what Dr. Glicksman or Dr. McGuire can and cannot achieve. A good plastic surgeon always works with the patient, making decisions together. “It’s a team approach,” explains Dr. Glicksman. “The ultimate goal is for a patient to wake up and say, ‘This is exactly what I dreamed of’.”
Simply put, experience matters. It’s an obvious statement, but with experience comes both further knowledge and wisdom, both of which combine to inform the most skilled of surgeons. Over the years, Dr. McGuire and Dr. Glicksman have seen most of everything. Every breast augmentation consult comes with this wisdom and experience for every patient to utilize. For them, a successful surgical outcome always comes down to planning. They plan exactly how things will go down in the operating room before they ever step through the door. Then, they execute that plan.
Both have also come to realize that tracking and maintaining a patient after surgery is just as important as the surgery itself. Dr. Glicksman sees her breast patients every year or every two years — forever. “I don’t discharge a breast implant patient,” she explains. “They have a device that has to be replaced eventually. Well, replace it with me!”
Aesthetic Changes in Breast Surgery
Breast implants have changed a lot over the years, but so have patient aesthetics. Dr. Glicksman has patients who wanted larger implants in their 20’s that now no longer work in their 40’s and 50’s. “I’m growing older with my patients,” she shares. “We’re becoming more practical.” They might have back problems or maybe they’ve gained some weight or are going through menopause. A lot of patients opt to remove their implants and focus on their face instead. Bottom line, patients are, “starting to get older and a little wiser”.
Dr. McGuire agrees. She finds that patients are lot more sophisticated than they were when she first went into practice. Today, patients will come in with a list of things that they want. They know about the different types of implants. They know the difference between a breast lift and a breast implant. They know about the pros and cons of the various incision placement options. And as far as aesthetics go, patients today want a more natural look, not one that is obviously augmented.
Pre-educated patients makes the process easier, especially when it comes to explaining why a certain sized implant will be detrimental in the long run. Whereas before it may have been difficult for patients to visualize or understand, now devices like 3D imaging can help tremendously in the consultation room. Also, the tremendous amount of stories on cosmetic surgery social media pages actually can do a lot of good when it comes to helping patients understand the process.
Dr. McGuire says she is more comfortable today with the procedures because she’s been performing them for 25 years. However, all of the advancements in implants and surgical techniques still keeps the procedures challenging, which she says helps her keep feeling young. After 27 years, Dr. Glicksman continues to love being in the operating room. Patients curious about breast augmentation should seek out these types of surgeons – board certified and heavily experienced in the procedure in question. When a patient is open to education and trusting with an experienced surgeon, great results lie ahead.