How accurate would you say Crisalix is? (Photo)

Question

I am having a hard time choosing between 415 and 385cc. Since I’ll be going under the muscle, should I choose the larger size? I feel like I have very little breast tissue to begin with so If i chose the smaller size, I won’t loose that projection I keep reading about from some reviews on here. Thoughts?? Thank you.

Urmen Desai, MD, MPH, FACS · Answer

Crisalix is quote accurate.   I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS), a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach TrainedDouble Board-Certified, Double Fellowship-Trained Beverly Hills Plastic Surgeon

Donovan Rosas, MD · Answer

3D imaging software is helpful but by no means a guarantee of outcome.When sizing patients, there are a number of useful tools besides 3D imaging including:
-Breast sizers (rice bags)
-Goal photos
I also recommend that patients commit to a particular look rather than a cup size. Once a patient settles on a look that pleases them the overall cup size increase becomes less relevant.The key to obtaining a natural result is to stay within the parameters defined by your BWD. This will ensure that you avoid the dreaded "fake" look. I have found that 3D imaging is most helpful as a tool for narrowing sizing options to a smaller range. It can also offer volumetric analysis which in some cases is helpful. Vectra vs. Crisalix is debatable (although there are studies on the accuracy of Vectra).As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Daniel Barrett, MD · Answer

Dear backtoprebaby,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

Dallas Buchanan, MD · Answer

Thank you for your pictures and questions. I think that Crislix is a very good system but make sure you keep in mind that no photo system is perfect. They are merely computer renderings of predictions and in no way assure any specific outcome. The best thing you can do is choose a plastic surgeon who is board certified by the American Board of Plastic Surgery and follow his or her expert advice. In reality, the implants you are choosing between have a volume different of 30 cc and in the photos I can barely tell them apart and I think the same will go for you as well. 30 cc is only about 7% of the total implant volume, so obsessing about this choice is really unnecessary because you will likely be happy with either choice. All that being said, plastic surgeons very rarely if ever have patients come back saying they chose an implant that is too large, while the opposite does happen on occasion.Hope this helps!

David A. Sieber, MD, FACS · Answer

I think 3D imaging can be a very powerful tool if it works well. I originally started using Crisalix when it came out and had to stop using it because I think it over estimates the actual post surgical size. A lot of people like it but that wasn’t my experience. I now use a machine called Vectra which has actually been studied and was found to be able to predict final post op breast size with 95% accuracy. I’ve been very happy the Vectra results, as have my patients. I hope this helps!Best,Dr. Sieber

Jeffrey H. Lee, MD · Answer

Hi and thank you for your question.  Any 3D technology comes with drawbacks and limitations.  The biggest one is that they are adding the dimensions of the implant to your breasts which can react very differently based on a variety of factors such as age, kids, etc.  That being said, I think the 3D rendering is not giving you an accurate representation.  I would recommend going and putting some implants in a tight fitting sports bra to give you additional information on what you want.  Good luck!

Curtis Wong, MD · Answer

and they always will add a disclaimer to any kind of 3D imaging systems used to predict the future outcome.  Despite what Dr. Pousti feels, I have found the Mentor sizing system using shaped sizers of different volumes to be quite accurate when using an unlined bra with a light colored top over that.  My patients have been very satisfied with their choice with the most common complaint still being 'I wish I went larger' once they have healed and settled.  I find it archaic to allow your surgeon to choose what is best for you as you will find many unhappy tales where the patient ended up not getting what they wanted... and this doesn't help the patient doctor relationship at all.  My patients pick the size they want and its my job to find out what profile will best fit on their body.

Tom J. Pousti, MD · Answer

Although useful as rough guidelines and as communication tools, all the modalities currently used to predict what breast implant size/profile will best achieve a patient's goals with breast augmentation are NOT very accurate, in my opinion. The use of the rice test, sizers placed beneath a patient's bra, goal pictures, computer imaging technology… are all useful, but not necessarily as accurate as one would hope.
In my opinion, nothing will replace careful verbal preoperative communication with your plastic surgeon, preferably in front of a full-length mirror along with the use of as many "communication" tools” listed above.
In my practice, I use all of the above modalities and then use intraoperative temporary sizers to help determine the best breast implant size/profile to achieve a patient's specific goals as closely as possible. For this reason, I think it is helpful to have the entire range of breast implant sizes/profiles available in the upper room.
In my opinion, it is not possible to accurately determine how many ccs (if any) a patient would “lose” when undergoing sub muscular breast augmentation surgery. I suggest patients do not make decisions based on statement such as: “you will lose 25 or 50 cc of volume when breast implants are placed under the muscle”. These statements are simply not reliable enough… 
Given your questions and concerns, I would suggest that you schedule additional time to spend with your plastic surgeon. This additional time spent will be helpful in the communication process and in alleviating some of your anxiety.
Best wishes; hopefully you will be very pleased with the outcome of the planned procedure.

Jon A. Perlman, MD (retired) · Answer

After 3+ decades of performing breast augmentation surgery my feeling is that computer analysis and even dimensional measurements are useful but lack precise accuracy.  For example patients with the same dimensions may differ vastly in the expandability of their skin and breast gland based on age, pregnancies and history of weight change.  
We each as surgeons find what seems to work best for our patients and my technique involves a careful assessment of the patient's size and contour goals combined with the use of intraoperative sizers or test implants to visualize most accurately an anticipated outcome.  
I feel that it is very important to have your surgeon take responsibility for the final implant selection based on your goals, goal photos, and the actual appearance of your breasts during surgery when "sizers" or test implants are positioned with you asleep but in a semi-upright position.  I believe that seeing the actual results using different volumes gives your surgeon important aesthetic flexibility and accuracy in matching a patient's goals rather than placing the burden of decision on them based on stuffing a bra, etc....
  
You'll enjoy the attached video for more information.  Best wishes,
Jon A. Perlman, M.D. FACS
  
Certified, American Board of Plastic Surgery
  
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
  
Member, American Society of Plastic Surgeons (ASPS)
  
Beverly Hills, Ca.

Lawrence N. Gray, MD (retired) · Answer

I use the Crisalix imager and find it to be very accurate, much better than using sizers. Generally, if a patient is unsure about size, I tend to suggest using the larger size. A larger size will have more projection. It is hard to give an accurate suggestion without knowing your actual breast width. I suggest not using an implant wider than the actual breast for a more natural look.

How accurate would you say Crisalix is? (Photo)

Answers (10)

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