When doing an exchange of implant, are markings (drawing on the chest with pen) always necessary?

Markings help a surgeon to plan for adjustments in implant position. In rare cases when the implant is just being exchanged without changing size or position on the chest, these marks may not be needed. But most of the time they are needed because things shift when you lay down on the operating room table. Legally, at least the surgeon’s initials or some marking is needed to verify the surgical site.

These are good medical practice and it depends on surgery planned specially any capsulotomy or moving the implants more medially to give better leakage.

Practice and markings vary from surgeon to surgeon. It is a good idea to draw some markings that guide the surgeon as to where the chest median is and where the neo infra mammary crease is going to be. It gives the surgeon an indication of where the pocket for the new implant should be. Also, it is good practice to write the details of the implant which can be crosschecked with the implant being inserted, particularly useful if different size implants are being used on each side.

For optimal outcome, please consult a fully qualified plastic surgeon, who has specialist qualification in plastic surgery 'FRCS Plast' after having being trained adequately in the field of plastic surgery, is registered on the 'Specialist register for Plastic surgery' with the General Medical Council and has been considered competent enough to be a member of the 'BAPRAS' (British Association of Plastic Reconstructive and Aesthetic Surgeons) and 'BAAPS' (British Association of Aesthetic Plastic Surgeons) at the least.

Dear Djm61,
it is hard to tell for sure but every surgeon has a different protocol. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

I prefer to draw just prior to surgery to make sure all details are addressed. Many ladies are not symmetrical when standing, but look fairly even when laying down.