If a surgeon doesn't take measurements during the consultation, how do they know which implant size and profile to pick?

Question

I hear that some PS don’t take measurements during the consultation or only do it the day of the surgery, in this case how do they know which implant size and profile to pick and order ahead?

David Parizh, DO · Answer

A board certified plastic surgeon should help you obtain implant sizes that are realistic and appropriate for your aesthetic goal. In my practice I routinely measure your breast width to help guide what types of implants would be appropriate for you. 350cc can be:1. more narrow and more projecting 2. wider and less projecting 
These measurements can be used to pick an implant style to suit your needs. 
I find many patients want to dictate their sizes based on their friends augmentation and end result. Your natural breast width and goal are unique. You need to have someone explain that to you and the risks of pushing your "skin envelope" beyond your limits. This is why people have complications post-operatively.
I routinely slow down and listen to my patients end result to design a surgical blueprint for a successful surgery. 
Hope that helps.

Fernando Ovalle Jr., MD · Answer

Hello, in my experience, measurements, sizers and 3D imaging preoperatively can all be important parts of the consultation and shared decision-making process between the surgeon and the patient. However some surgeons may be more comfortable with "eye-balling" certain things at different steps in the process due to their experience. Some surgeons may also keep a large consignment or stock of implants in their office/operating room and this can allow them to pick between various sizes and profiles more easily when needed. These could be good questions to ask during your consultation with a board certified plastic surgeon as I think feeling comfortable with your surgeon and their communication skills is an important part of the process for patients!

Martin Jugenburg, MD · Answer

Hello, thank you for your question. Each plastic surgeon can be a bit different in their process of choosing implants. Our practice I like to have a range of sized base on measurements. For more information check out website below.

Richard Baxter, MD · Answer

Most plastic surgeons would take measurements especially the breast width in order to select the right implant. Personally I have the patient very involved in the planning so that they will know what they are getting. There are 3 important aspects to consider: size (volume), width (base diameter) and projection. Any two of these determines the third; for example, if you know the size and projection, you also know the base diameter. Base diameter is most important because it depends on the width of the breast.

Ted Eisenberg, DO, FACOS, FAACS · Answer

I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants, and they choose what looks right for them. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Daniel Barrett, MD · Answer

Dear nounouk,
breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Ronald J. Edelson, MD · Answer

If you’re talking about breast width measurement I don’t do it either. That concept was introduced about twenty years ago. Many surgeons adopted it thinking that it was so accurate and patients would be impressed. But it has turned out to be a faulty way to choose implant size. I prefer a combination of a patients desires and a surgeon's experience. It honestly doesn’t need to be complicated

Chuma Chike-Obi, MD · Answer

Hi,
Many of us have what's called a consignment inventory. This means that a surgeon may carry a wide range of implants from her/his preferred breast implant manufacturers. These stay on-site at the surgery center, meaning that last-minute changes can be made without affecting the plans made by the surgeon and patient.
Best,Dr. Chike-Obi

Camille Cash, MD · Answer

It is important that you feel comfortable and confident as you select your surgeon and prepare for surgery.  During a consultation typically surgeons will take measurements and discuss recommended implant options based on your goals.  There are times when more than one implant may be on option on surgery day depending on which best fits the breast space, but this should all be discussed beforehand.  If you have questions about a surgeon's approach I encourage you to ask.

Connie Hiers, MD, FACS · Answer

I like for my ladies to be happy with the size selected. I spend a lot of time examining, measuring, and letting patients try on a range of sizes that best fits their frame and tissue.  This way, the size decision is made together. Patients know what they can expect and there are no surprises and much fewer disappointments.

If a surgeon doesn't take measurements during the consultation, how do they know which implant size and profile to pick?

Answers (14)

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