This question may sound silly, but I am feeling high anxiety about finding a PS to do a revision on my previously revised breast aug. Before having my 1st aug I didn't do my homework. I trusted that my previous PS would take into consideration such things as "base width" and the tightness of my breast folds. I have a couple consultations coming up and I was just wonder what kind of questions a PS should be asking. And what kind of questions I should ask. Please see my previous question for more info.
How Should I Prepare for Breast Augmentation Revision Consultation with New PS? (photo)
Doctor Answers 7
Preparing for a Breast Augmentation Revision
How Should I Prepare for Breast Augmentation Revision Consultation with New PS?
Best to bring before photos from the first surgeon. Write down the second opinions surgical plans, so you can review later.
The most important thing you should ask is has the surgeon treated your type of problem and how many times. It looks like your implant has bottomed out and your may need internal suturing to re-establish the inframammary crease. Not every surgeon has extensive experience dealing with that problem.
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Preparing for consultation after revision augmentation
Usually the main thing an experienced plastic surgeon needs but doesn't have in a consultation/exam after a previous breast augmentation, is the details of the implant in place (size, type, shape, surface, fill). The rest can be determined in an exam. In the case of a previous revision after an earlier breast augmentation, a good description of what was done during the revision would be helpful. This might require the op report or communication with the revision surgeon.
The key is in identifying the exact problem and how it would be adjusted or corrected. This should be as simple and defined as possible, particularly on a second revision.
Preparing For Revisionary Breast Surgery?
Thank you for the thoughtful question.
Patients who have had previous breast surgery, and are seeking revision breast surgery, often present with an increased anxiety level ( understandably). Plastic surgeons well experienced with revisionary breast surgery will initially attempt to determine exactly what the patient's concerns are. In other words, what is it about the patient's breasts that they do not like and exactly what do they want to achieve. Both of these questions can be best answered in front of a full-length mirror. The use of goal pictures are also helpful during this communication process.
Once this communication process has occurred, a well experienced plastic surgeon should explain the process of how to go from “point A” to point B”. Patients should not hesitate to ask to see previous examples of similar situations. Talking to previous patients may also be helpful.
Ultimately, patients will need to develop a sense of confidence that the plastic surgeon they are considering, has significant experience helping patients with revisionary breast surgery. Developing this confidence prior to surgery will help alleviate anxiety significantly.
Of course, another responsibility that we have as plastic surgeons is to help the patient achieve realistic expectations as to what can and cannot be accomplished. Improvement, not perfection, should be expected.
Also, discussing postoperative activity levels, very important when it comes to success rates after capsulorraphy surgery (for example) will also be important.
You may find the attached link helpful to you as you learn more about revisionary breast surgery.
Revision Breast Augmentation
Questions should center around the plastic surgeons philosophy of revision surgery and his experience. Base width is one of many parameters that are important in sizing a patient either for primary or revision surgery. There are other measurements that are just as important, especially for primary surgery.
Your situation warrants consideration of 1. Return of imframammary fold to an optimal position, 2. Assessing the need for additional support with an acellular dermal matrix like Alloderm or Strattice, 3. Choosing an appropriate sized implant. Each of these considerations should be elaborated on by the surgeon in his discussion with you, and it should be easy to understand the reasoning for each step in the surgical process. Photos should show examples similar to yours.
Just relax while on your consultations. The right surgeon should make you feel comfortable and confident that you will be taken care of appropriately.
Best of luck!
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.