All Shapes and Sizes

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All Shapes and Sizes
by Michael Tantillo, MD

Breast augmentation changes the size and shape of a woman’s breasts. How do we decide before surgery what size and shape her breasts will be after the surgery? Some surgeons simply ask the patient what cup size she wishes to be and then figure out what implant to use when in the operating room, others will simply ask the patient to fill a bra with a sizer she likes and then use an implant of that size in the operating room. The most common reason that women have their implants removed during the first three years after the initial surgery is to change the size and or shape of their implants. So, we can need to be precise when selecting the implant size, style, and shape. There are four major pieces of the consultation that help us decide on the proper size and style implant that will achieve the patient’s goals from the surgery.

First the patient tells me her goals and expectations from breast augmentation. We discuss how much volume enhancement she wishes, what cup size bra she wants to be able to wear, what changes in the shape of the breast she wants to achieve, and how she wishes to look in clothing. During the examination we pay particular attention to the breast shape, the breast dimensions, the quality of the soft tissue, and the patients overall body shape and size. We then select a bra and use implant sizers to assess the volume enhancement that she desires. Finally we review photographs of other patients before and after surgery and discuss what she can expect with following her surgery. Based on all of this information an implant of a particular size, style, and shape is chosen to meet the patient’s expectations.

How you look after your breast augmentation should not be a surprise; you should be the size and shape that you expected to be. With careful dialogue and examination before the surgery the chance of additional surgery to change the implant size, style, or shape after surgery should be very low. Remember each surgery has risk and expense; so getting it right the first time is safer, cheaper, and gives you the result that you want more quickly.