Breast Enlargement: A Surgeon's Perspective
After performing over a
thousand breast enlargement
surgeries since 1996, I have
learned a few things that I
would like to share with you.
If you are considering breast
enlargement, I hope that these
principles will help guide you,
as they have guided me.
There is no substitute for personal service.
As most of us already know, if you want something done right, you have
to do it yourself. For me, this means performing my own consultations and
preoperative visits, personally addressing all questions, performing the
entire surgery myself, and seeing every breast enlargement patient at every
postoperative visit. While it would be convenient to have O.R. technicians
stitch up my incisions and medical assistants perform my postoperative
visits, I believe that doing these myself is simply the right thing to do. My
surgery center only has one operating room because I only operate on one
patient at a time.
Even though it’s cosmetic surgery, it’s still surgery.
There is no such thing as a risk-free surgery. But we can and do take active
measures to make surgery as safe as possible. Our nationally-accredited
ambulatory surgery center, the Plastic Surgery Center, is
located on the campus of Presbyterian Hospital. All anesthesia is
administered by physician anesthesiologists, not nurses or technicians. Our
facility has an excellent track record for safety. And I don’t go home for the
day until the last surgical out-patient is awake and stable to go home.
If you’re looking for art, go see an artist.
Surgeons routinely advertise that they will “sculpt” your breasts (or your
nose or your thighs). But let’s face it: most surgeons have no experience
in art or sculpture. In contrast, I have had the opportunity to create a large
number of wood and marble sculptures over the past 25 years. Many
of these pieces have been displayed in galleries or sold by commission.
Placing a breast implant is not a sculptural masterpiece. But I sincerely
believe that having an artistic eye has made me a better plastic surgeon.
Elective surgery should never be performed with
a stopwatch.
Many surgeons perform breast enlargements in well under an hour. I take
about two hours. I simply believe that it takes time to do it right. Most
surgeons use “blunt dissection,” which involves tearing tissues with a
gloved finger or blunt instrument. In contrast, I use electrocautery, which
involves heat-sealing the tissues to reduce bleeding and prevent bruising.
This eliminates the need for postoperative drains, compression bras, and
ACE wraps. I also use sample implants called “sizers” to preview your results
on the O.R. table before selecting and placing the actual implants. This
reduces guesswork and provides more predictable surgical results. These
maneuvers add time to the surgery, but I look at it this way: it’s a couple of
hours out of my life—but it’s the rest of yours.
Results matter, and they matter a lot.
The most objective way to evaluate surgeons is to let the numbers speak
for themselves. According to recent data submitted to the FDA, 26% of
women undergoing breast enlargement required further surgery within 5
years. My 5-year re-operation rate is under 8%. To the extent possible,
I try to keep my patients happy and my re-operations to a minimum.
Because if you don’t look good after surgery, neither do I.
Don’t be afraid to shop around.
It’s your body. It’s your decision. It’s completely elective. Take your time.
Look for a surgeon who:
1. Is Certified by the American Board of Plastic Surgery.
2. Performs breast enlargement surgery at least once a week.
3. Has privileges to perform breast enlargement at a local hospital.
4. Has a large number<
Ronald M. Friedman, M.D. offers breast augmentation surgery in:
