Size correction with only 10cc more?! What?!

Question

So my BA is only 3 more weeks away. My doctor charged me an extra 500euros (yes euros, we are currently in Germany :) ) to correct the minimal size difference I have but suggested 345 on one, 335 on the other. After gathering all this info about BA's that NO DIFFERENCE at all, right? I was so confident about the choice I made with my PS and now I'm really second guessing myself. I've seen before and after's, my consultation was outstanding, but this is really getting the best of me. Help?

Scott C. Sattler, MD, FACS · Answer

We plan each breast augmentation for our patients based on their individual cosmetic goals, their anatomy and the implants that we have available. We NEVER charge a patient  'extra' money to make modifications to the standard breast augmentation (ie. use a larger implant on one side etc) if we believe it will improve the outcome of the breast augmentation. Seek a second opinion.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  The size,
profile, and shape of the implant is based on your desired breast
size/shape, your chest wall measurements, and soft tissue quality. 
This decision should be based on a detailed discussion with
equal input from both you and your surgeon.   Make sure you
specifically look at before and after pictures of real patients who have
had this surgery performed by your surgeon and evaluate their
results.   
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Vaishali B. Doolabh, MD, FACS · Answer

Hi MommaAA.  I agree-10 cc is a small amount, and would not compensate for significant differences between breasts. There are differences in the musculoskeletal frame, breast tissue and skin envelope from side to side in every woman.  The implant will not be able to compensate for everything, so persisting asymmetry is normal & expected. The diameter and projection differences in the implants of 345cc & 335cc, if any, are on the scale of 1-2 mm.  Keep in mind that saline implants have a range in which the volume of saline can be filled, per diameter & projection-perhaps that led to the recommendation?  With silicone gel implants, you have to choose different implants altogether,.  Consider trying on the two sizers or imaging software to estimate the outcome.  Lastly, it is not common to charge a separate fee for "correcting" differences between breasts-it is a standard approach to optimizing outcomes. Talk to your PS about your concerns.

Curtis Wong, MD · Answer

to be charged an additional amount to use different sized implants... and if saline, even more so since you fill it at the time of surgery.  This would be considered unethical in my opinion but if you're locked in due to the scheduling policies, you may be stuck.  You can still cancel and vent on social media in German... because shenanigans such as this only give the rest of the legitimate surgeons a bad reputation.  10 cc's is inconsequential and if you really have a size difference, you better use more and even risk making that one larger in the end rather than still smaller.  These comments based on your side of the story... just maybe your surgeon has a legitimate reason for that policy.

Robert S. Houser, DO · Answer

Everyone can make their own rules but that's rediculous! 10cc is 2 teaspoons. And why charge extra? I would find another surgeon just for that! Or, just use the same size and save the 500 euros! They may also have a cancellation policy so watch out.

Mehdi K. Mazaheri, MD · Answer

Thank you for your question. Photos would of been helpful. I have major concerns. Why are you paying more more money if you have slight breast asymmetry ( EVERYONE has it, breasts are sisters NOT twins)? " 10 cc difference" is not clinically significant. Get another opinion. Good luck. DrMaz

Tom J. Pousti, MD · Answer

Thank you for the question.  Although much depends on the specific patient's body type and current breast asymmetry,  a 10 cc difference in breast implant volume rarely creates a significant amount of a difference to be clinically noticeable.
***Given that your surgery is coming up soon, I would suggest that you spend additional time communicating your goals/concerns directly with your plastic surgeon, preferably prior to the date of surgery.
 Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant size/profile selection) is:
1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. ***Ask to see lots of examples of his/her work.
2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. 
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, 
I have found that the use of words such as “natural” or "C or D cup” etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.
3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers.
I hope this (and the attached link, dedicated to breast augmentation surgery concerns) helps. Best wishes for an outcome that you will be very pleased with.

Jon A. Perlman, MD (retired) · Answer

Your concern is well based.  I think that anything less than 25 mL would make a nearly imperceptible difference.  At least 85% of women are asymmetric when comparing one side to the other and making breasts larger often makes this less "important" but will not create perfect symmetry under any circumstances.  With this confusion and added cost, similar to the other doctors, I would recommend that you seek a second opinion.

Ronald V. DeMars, MD (Retired) · Answer

Yes, you are right in that 10cc is a miniscule amount of difference and definitely not worth the cost nor the risk of a surgical procedure.

Size correction with only 10cc more?! What?!

Answers (9)

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