Is it normal for your surgeon to want you to choose your implant?

Question

Hello! My surgeon is waiting for me to finalize what size I want based on putting the implant in a surgical bra. The reasoning is I know what's best for my body, but the reality is I do not. I have no idea what I need to achieve the look I'm going for and its frustrating to not get any guidance. There were no measurements taken until I asked, and i'm not even sure how to apply the measurements. The surgeon didn't even ask for insp pics. Is this common?

Derek Fletcher, MD · Answer

Proper implant selection requires detailed knowledge of the right and left breast measurements, soft tissue type, skin type, and nipple position. It also requires detailed understanding of the patient's goals. I like to review at least 10 goal photos with my patients as well as examples of results that are too small and too large. I want to go to surgery with the most precise understanding of the goals of surgery as possible. Depending on the implant type to be used (smooth round vs. textured anatomic), I have 4 to 8 different implant available so that I get the results the patient wants to achieve.

Brian K. Reedy, MD · Answer

Hi & thanks for your question!
Schedule an appointment with your surgeon's office. Try on different sized implants to see what look you like best. The office staff should be able to help you out with this and offer you guidance.  Best wishes!

Ted Eisenberg, DO, FACOS, FAACS · Answer

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size breast implants. 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 is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Tania Najar, MD · Answer

While inspirational pictures could help, it is indeed common for surgeons to attempt they are aligned with patients on size, with trying on the surgical bra as a great first step.

Ricardo Vega, MD · Answer

Hello, thank you for your inquiry! As a plastic surgeon after an evlauation we will recommend what is best for your body, and we will also try on sizes so you can have an idea of what it will look like trying on the implants before surgery as well. You can also show your wish pictures for your surgeon to have an idea of what you are expecting as well and make sure you can achieve. I suggest seeking a board certided plastic surgeon with experience to go over further details. Best of luck!

Daniel Barrett, MD · Answer

Dear Genius188143,
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

Camille Cash, MD · Answer

From your description your encounter with your surgeon seems to have left you with more questions than answers.  I encourage you to return to your surgeon for guidance on implant selection.  If you are not having your questions answered or are uncomfortable it may be a good idea to visit with other board certified plastic surgeons.

Daniel Crane, MD · Answer

Your surgeon should assist you in choosing an implant that will safely achieve your goals. Each patient is different in terms of their desires and anatomy. It is our job as surgeons to try to understand what the patient desires and educate them about what size implant will fit within a specific anatomy. I typically review goal photos with my patients and use a volumetric sizing system. The patient and I determine a range of sizes that we have both agreed upon and I make the final decision on implant size after placing sizers during surgery. Hope that helps.

Connie Hiers, MD, FACS · Answer

You might consider seeing another surgeon who can better guide you. I measure all my ladies and discuss the range of sizes best suited for their frame and tissue. They then try on these sizes to see what they like. Once they decide on surgery, they come back for a preop visit and we discuss/try on sizes again to be certain. Some do bring photos to the consultation and I discuss what is reasonable for the patient compared to the photos.

Antonios Mitsakos, MD · Answer

For the surgeon to give you options when it comes to implants is common practice. By this I mean that because at the end of the day you are the one deciding how you want to look you should be the one making the final decision. But this would be within limits of what is recommended by your surgeon with the adequate guidance by them. It all depends on what your anatomy can comfortably accommodate and what suits your needs and your lifestyle. thorough clinical examination, understanding of your aesthetic goals and measurements as part of your clinical examination are a given.

Is it normal for your surgeon to want you to choose your implant?

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