Is 400 cc enough?

Posted on February 5, 2013 by pastiche1

by Terrye Tebbetts

Question:

So ladies I need ya’ll with experience! I am a 34 A right now, and the docotor said 400 cc would be a good look for me.  I really am afraid that I am going to small because I want a full D if not DD cup.  Is 400 cc’s a correct fit, or do I need to go larger? Any one?

Answer:

A really good idea of where your breasts can SAFELY go is where they have been stretched to before – ie pregnancy.  That is what High Five gives us – clinical measurements that tell us how much your breast needs.
I know it’s hard – when you have wanted implants for so long and it’s cosmetic….you tend to think you can just order up what you want.  And it’s true, you can put any implant in any breast, but you can’t hide from your own body, what you start with , what your tissue is like and you certainly can’t run from gravity.  There are limits  – you bring them to the surgeon and the OR table.  We cannot change those limits and if you and your surgeon chose to ignore them…well, that is what, I think, has given breast implants such a bad rap.  Boob Jobs happen when patients and surgeons ignore limits.
I think the old adage “Be careful what you wish for” says it all here……this is surgery that will change your body forever.  Please let clinical measurements plan your operation…not guess work.  You may very well need that 400 – - but I would like clinical proof that you do.
Which means – part of the delima of achieving a safe, natural result with a breast implant may mean that you have to adjust your expectations if your body won’t comply.

About the Author: Terrye Tebbetts is one of the most knowledgeable women in the world about breast implants, with 27 years of experience educating patients and 11 years as a patient herself. For more information about breast implants or breast augmentation Dallas surgeons, please visit www.thebestbreast.com

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Incision Location for Breast Implants

Posted on December 14, 2012 by pastiche1

by Terrye Tebbetts

Boy, have times changed in the incision location department!  When the FDA took the old silicone gels off the market in the 1990′s, we were forced into using nothing but saline implants for over 16 years.  Saline implants come to the surgeon empty and are filled through a valve after they are placed (one of the reasons they have such a high failure rate) in the pocket.  Placing an empty implant left us with a lot of incision options – endoscopic axillary, peri areolar and inframammary – were all incision options.
Now, with the advent and use of thicker silicone gel implants, we are limited to mainly the inframammary (under breast, crease) incision.  This incision option provides maximal accessibility without compromising the implant shell or filler.  The inframammary incision has always been the leader in fewer risks – it is always hidden in the crease under the breast, the surgeon only has to pass through minimal tissue and he is in the pocket, it does not increase risk of infection or sensation loss (like PA incisions do).
All of Dr. Tebbetts incisions are closed from underneath the skins surface, avoiding track marks on the skin that might be visible later.  The stitches dissolve on their own and require only a small piece of brown, paper tape to cover them.  This piece of tape is your only “bandage” and it comes off on its own in about two weeks.

About the Author: Terrye Tebbetts is one of the most knowledgeable women in the world about breast implants, with 27 years of experience educating patients and 11 years as a patient herself. For more information about breast implants or breast augmentation Dallas surgeons, please visit www.thebestbreast.com

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Breast Implant Pocket Location – Over vs. Under vs. Dual Plane

Posted on December 7, 2012 by pastiche1

by Terrye Tebbetts

Determining where your breast implant will be placed in your body is a  very important decision in planning your breast augmentation.  For Dr. Tebbetts,  this determination goes back to the measurements – it goes back to YOUR body.

If you have 2 cm or less of pinch thickness in the upper portion of the breast, the breast implant needs to be placed under more of YOU to camouflage it over time – make it age better with you and make your mammograms the best they can be over time.
Dr. Tebbetts developed and published the Dual Plane method in 2005.  I hope the illustrations in this link will help you understand the difference between over, under and dual plane.  http://www.thebestbreast.com/about/breastaugmentationdallas.php

We would be happy to discuss any specific questions you have about pocket location. P.S… nobody’s implants are completely “Under” no matter what your buddies told you – it’s just a phrase that is very commonly used amongst patients and surgeons.  The breast implant is usually place partially under the pectoralis muscle covering the upper third of the implant.

With Dual Plane placement, Dr. Tebbetts’ patients still experience a 24 Hour Recovery.  Returning to full range of motion the afternoon of surgery – so with no added down time for patients, they still get the best soft tissue coverage for their implants with the Dual Plane technique.  The more of YOU that covers the implant, the better it will age with you and the better your mammograms will be in the long run.

About the Author: Terrye Tebbetts is one of the most knowledgeable women in the world about breast implants, with 27 years of experience educating patients and 11 years as a patient herself. For more information about breast implants or breast augmentation Dallas surgeons, please visit www.thebestbreast.com

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Breast Implants – How do you know which one is best for you?

Posted on December 2, 2012 by pastiche1

by Terrye Tebbetts

When considering breast augmentation, one of the major options and choices a patient has is the type of breast implant the surgeon will use.  However, when you ask most women who have had implants, they don’t know what type of implant they have!  You and your surgeon will make that decision together and after surgery, you should recieve implant ID cards and warranty information.  This documentation should be kept with all of your insurance paperwork for future reference.

We have learned a lot about breast implant devices over the years and they just keep changing.  In fact, since we went to press with TBB2 and now, everything has changed, making Chapter 5 in TBB2 out of date.  After careful review of the data available, at this time, Dr. Tebbetts prefers the safety and longevity characteristics of round, smooth cohesive silicone gel breast implants.  These implants have been approved by the FDA since 2006 – for both American manufacturers, Mentor and Allergan.
Each company has slightly different sizes to offer, so Dr. Tebbetts prefers to use your measurements (the High Five System) to determine which manufacturer will be the best fit for your breasts.  Each company offers long term warranties as well – we provide each patient with manufacturer’s handout material, implant serial number cards and warranty information after surgery.
We are happy to discuss all the implant questions that you may have, like: “Isn’t saline safer?”, “What happened to textured implants?”, “What about shaped implants?”  Ask away and we will be happy to discuss what we know, given the data available, at the time. It is very important to remember that what makes a pretty, natural breast is NOT the type of implant that is used, but HOW the breast implant is used – the size chosen and pocket location chosen.  In other words, if the breast implant size simply fills the breast envelope (not pushing it) and the proper pocket location is used to give adequate soft tissue coverage over the implant, it could be any shape, fill, or shell type and it will look natural on you.  It is not the implant – but how the implant is used that makes you a pretty result!

Choose the best implant product to improve safety and longevity of your result.  Choose your surgeon to help you work with your body to make the implant beautiful and natural.

About the Author: Terrye Tebbetts is one of the most knowledgeable women in the world about breast implants, with 27 years of experience educating patients and 11 years as a patient herself. For more information about breast implants or breast augmentation Dallas surgeons, please visit www.thebestbreast.com

 

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Breast Augmentation – How to Determine the Size and Look you want

Posted on November 30, 2012 by pastiche1

by Terrye Tebbetts

How to choose the breast implant size for each patient is probably the most heated debate for surgeons and most worried about option/choice for patients.  The most common methods are all subjective and mean nothing when it actually comes down to walking into the operating room – ie – putting sizers in your bra, talking cup size, looking at photos of other people, 3-D imaging, and we can’t forget one of my personal favorites, the rice test!  Let’s face it, patients are either worried that they will be too big or not big enough.  Although talking “full C” with your surgeon or bringing him or her a photo of what you want to look like may make you feel all warm and fuzzy at the time, I guarantee you, when you leave your consult, you will be wondering if they actually understood what you want.
Dr. Tebbetts makes all surgical decisions about how to change a breast – whether it needs augmenting, lifting or reducing – based on a scientifically proven and published measurement system called, The High Five System®.  It is so simple to use – even patients can measure themselves at home to get an idea of what their body – their breast is calling for.  It is five measurements that are applied to a formula – the answer gives you the CORRECT amount of fill for each individual breast…. every time.
By simply filling the empty breast envelope, the High Five System® produces beautiful, natural appearing breasts that are least likely to cause you more operations in the future.  So if you want to change your breasts – after time, babies, nursing, weight gain and loss – and yet you don’t want a “boob job”, the way Dr. Tebbetts approaches how to determine size – The High Five System®- is just the ticket for you!

About the Author: Terrye Tebbetts is one of the most knowledgeable women in the world about breast implants, with 27 years of experience educating patients and 11 years as a patient herself. For more information about breast implants or breast augmentation Dallas surgeons, please visit www.thebestbreast.com

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Saggy Breasts? Is Dual Plane an alternative to a Breast Lift?

Posted on November 28, 2012 by pastiche1

by Terrye Tebbetts

I hope everyone had a wonderful Thanksgiving break – I know we did and we were very thankful for the time off with our daughter!!  During the holiday I recieved a note from a patient I had consulted with by phone a while back.  I had advised her that, given her photos, she might need a mastopexy, instead of an implant (never go by photos – seek the measurements!).  Being familiar with Dr. Tebbetts techniques (24 Hour Recovery, High Five and Dual Plane), she thought to ask me the following when a surgeon she saw was touting Dual Plane 3 as a replacement for a Mastopexy or breast lift.  The following is our exchange:

Terrye,

I spoke with you some time ago and discussed a breast lift and later augmentation if needed. Are you familiar with a technique called dual-plane? It seems is some cases it avoids a lift and I was wondering if you had any advice about it?

Carol –

Familiar with Dual plane? Yes ma’am!  Dr Tebbetts developed and published it!!

Terrye,

Great, that’s what I thought.  Actually ours was a phone consult and it has been some time ago but I think you were pretty confident I would need a lift. There is a surgeon touting dual plane III as a way to avoid a lift. Just curious what your thoughts are on this approach, is success plausible or are you possibly begging for later trouble?

Carol –

Nothing.  Nothing replaces a lift if you really need it.  Dual plane is a tool in a surgeon’s bag of tricks, if he truly understands it, that can help him manage even the most difficult augmentation patients and yield better results.  However, if a surgeon is trying to skate the hard realities of what a patient might need and just use Dual plane as a marketing tool….shame on him or her.

Did I send you the measurement sheet when we talked?  If you can measure nipple to fold under stretch in cm, please let me know what t number is and then we can go from there.

If you really need a lift – it’s a wonderful thing, not a frankensteinish thing!  Tebbetts is publishing a paper right now on his very special techniques in mastopexy, funny you should recontact us now!

You can’t cut corners (or shorten incision lengths etc) on a procedure to apease the patient and get an optimal result.  Our job as plastic surgery professionals is to evaluate, measure and educate each patient about the procedure they need or want.  In my position as a patient educator, I spend most of my time helping patients reconcile what they WANT with what their bodies will realistically allow them to have.  Plastic surgery is not magic.  Each surgeon must work with what you bring them to work with….the trick now a days is to get the surgeon to truly be honest with you about the realities you BOTH face going into surgery.

It all comes back to the measurements – to High Five.  A breast implant has to go to the BOTTOM of the pocket or breast envelope it is given to go to.  If there is too much excess skin, then the breast after implant will be a bigger, saggier version of what it started out as – not lifted or perky – bigger, and firmer with more projection but NOT higher and perky.  I think the biggest problem is with those patients who are borderline – they aren’t really a candidate for a lift, but an implant won’t do what they want it to do.   These patients are the ones who usually get screwed by the system – - simply because most professionals are not willing to reconcile wants with reality.

Our job is to help patients achieve their goals and expectations.  We all LOVE happy patients.  Telling patients what they don’t want to hear is hard, but in the end, it is the only way I can sleep at night.  I wish they were all easy, but they aren’t.  Honesty is the best policy but often it is the hardest one to live by.  However, making one surgical technique try to replace the operation that is really needed is marketing hype that, in the end, produces unhappy patients.  I am so glad she brought this issue to my attention.  If you are thinking about breast surgery – measurements are truly the key to your success long term.  Seek surgeons who make clinical decisions based on objective criteria – based on measurements of your body.  And try to have an open mind as you research to the fact that what you thought you wanted might not be the right thing for you but there is a procedure that can help you – it’s all about balance.  If patients and surgeons communicate honestly this whole process is so much easier and successful!

About the Author: Terrye Tebbetts is one of the most knowledgeable women in the world about breast implants, with 27 years of experience educating patients and 11 years as a patient herself. For more information about breast implants or breast augmentation Dallas surgeons, please visit www.thebestbreast

 

 

 

 

 

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24 Hour Recovery in Dallas Texas!

Posted on November 17, 2012 by pastiche1

by Terrye Tebbetts

Well, there are 7 new pairs of beautiful breasts in the world today!!  When I called last night they were all over town by 6 pm – at swim meets, out to dinner, exploring downtown Fort Worth and taking care of their kids!  It is even one of their birthdays today!!  Happy Birthday – what a nice present to give to yourself!!  I love 24 Hour Recovery!!

About the Author: Terrye Tebbetts is one of the most knowledgeable women in the world about breast implants, with 27 years of experience educating patients and 11 years as a patient herself. For more information about breast implants or breast augmentation Dallas surgeons, please visit www.thebestbreast

 

 

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High Five Success Story!

Posted on November 16, 2012 by pastiche1

by Terrye Tebbetts

I think sometimes patients are afraid to ask their surgeon about other surgical methods.  Please don’t be afraid to ask them!  They should be happy to answer your questions about other surgical techniques – even if they don’t use them.

Surgeons are supposed to keep up with their own continuing medical education hours (CME credits) that means going to meetings and learning from other surgeons or reading the current literature in scientific journals.  So they should be aware of what is new and available to patients, even if they don’t use it.

If you and your surgeon decided implant size based on a traditional SUBJECTIVE method – cup size, stuffing sizers in bras, 3D imaging, photos of others – - you probably have some doubts about what it will actually look like – some grey area of uncertainty…..by asking that very same surgeon to apply a proven clinical measurement system, you can get rid of the unknown and feel comfortable about your decisions going into surgery.  It never hurts to ask them to use High Five to verify the sizer method…..all you have to do is ask.  One lady did and here is her note to me…..

Hi Terrye!

Thank you very much for offering to send me the High Five measurement sheet information, it’s so very appreciated.  As you know I am very nervous about going too large.  I have my pre-op appointment at 2:00pm today and the PS should be doing all his measuring then, I will mention the high-five system to him as I’m not sure what he uses.

Answer ~

Here ya go – sorry I just now got this – but you can always measure after your visit too!  Dr. Tebbetts says the system is so easy to use that patients can certainly use it at home before going into consults so they have some idea of what their own body will safely allow!

I guarantee it will never be too big if your body made the choice and simply fills the empty space.

Please let me know what you and the ps come up with!

Terrye,

You are a life saver!  Thank you so much I feel much better about everything now.  I just got back from my pre-op and did the measurements for the high-five system and my doctor recommended EXACTLY what you would have which makes me feel a heck of a lot better.  Yay!!

*hugs*

About the Author: Terrye Tebbetts is one of the most knowledgeable women in the world about breast implants, with 27 years of experience educating patients and 11 years as a patient herself. For more information about breast implants or breast augmentation Dallas surgeons, please visit www.thebestbreast

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Unnecessary Pain ~ Why is it so hard to believe there is a better way to have breast augmentation?

Posted on November 9, 2012 by pastiche1

By Terrye Tebbetts

I popped onto an implant forum this morning and saw another post about all the pain and restrictions after breast augmentation surgery.  The post was titled 7 Hours Post op…  “Hi Everybody. Well, I made it through and it hasn’t been too bad!! I’m a little loopy on the Percocet but not much pain. The hard thing is to remember not to reach up, around, etc right now – don’t want to do anything to undo all of this!”

This just floors me!  At 7 hours post op a 24 Hour Recovery patient has already eaten, showered, done her hair and makeup and is out and shopping and going to dinner taking nothing but Motrin!!  Better, more precise surgical procedures eliminate the need for pain killers and restricted movement.  Dr. Tebbetts developed these methods and  published and scientifically proved them so other surgeons could offer this better experience to their patients too.

24 Hour Recovery is a reality and not only does it limit pain and down time, but in the end, patients who resume normal activity and movement immediately also see lower risk of capsular contracture!

Ladies, there is no need to endure pain and drains and straps and ace wraps and pain pills and pain pumps and weeks of down time and higher reoperation risks!!  But you have to search out the new ways – you have to ask for 24 Hour Recovery – if you ask for it, then more ps’s will be motivated to change their ways.  Right now as it stands, going through a standard breast augmentation is like going through natural childbirth!  It hurts like hell but you still love your kids in the end.  BA hurts like hell but you still love your implants in the end (but with a higher risk of revision and reop)!

It doesn’t have to be that way but you – patients – have to demand the better, surgical procedure or it will never change.  As long as yall are willing to put up with the pain and the Percocet, plastic surgeons are not going to change – they have no reason to because yall will keep going and keep paying them to do it just as it was done and has always been done for 30 years!

Choosing to have a breast implant is something we want to do for ourselves – it is a luxury.  If you are going to choose to indulge in a luxury, don’t you want the absolute best you can for yourself?  Demand state of the art from your surgeons – if they hear it enough, you guys can change the way BA is done for the better.  As Jerry McGuire said in the move, “Help me..Help you!”  You are the patient, the one changing your body for life – you deserve the BEST!

 

About the Author: Terrye Tebbetts is one of the most knowledgeable women in the world about breast implants, with 27 years of experience educating patients and 11 years as a patient herself. For more information about breast implants or breast augmentation Dallas surgeons, please visit www.thebestbreast

Posted in 24 Hour Recovery, Back to the Basics, Breast Augmentation, Choosing a Surgeon, Recovery Experiences | Tagged , , , , , , | Leave a comment

Back to the Basics – Q&A Breast Implant Manufacturers

Posted on November 2, 2012 by pastiche1

by Terrye Tebbetts

Many cosmetic surgery websites have a helpful list of questions for you to have available when you go to your consults.  I thought it would be helpful to provide you with some answers ahead of time too!  It’s one thing to have the question, but if you don’t know how to evaluate the answer…..not sure how much good it will do you!

1.  What breast implant manufacturer and implant type do you prefer and why?

In Dr. Tebbetts’ opinion, surgeons should choose breast implants for each patient on an individual basis.  Each breast implant manufacturer has a slightly different set of pros and cons to offer patients.  Which one is right for the patient will depend on her measurements and tissue characteristics.

However, some surgeons work in an environment where they have to use only one type of implant.  And some choose an alliance with only one manufacturer.  Personally, I don’t think that is smart for the surgeon or the patient!

When you walk into a shoe store, is there only one style in one color?  If you walked into a store like that, you would probably walk out, right?  So why use a surgeon who only has one trick in his bag – - it’s supposed to be a bag of tricks – plural.

There are two primary US manufacturers  – Allergan and Mentor, with a third, Sientra gaining market share every day.  Under the 2006 FDA approval, you will find that Allergan and Mentor’s approved products are similar.  Sientra was recently approved earlier this year and their products differ a bit from the other two companies.  The message here is that there are options and choices – whether it is the characteristic of the breast implant or the warranty.  A surgeon should be well versed in all products and all available options.

While the breast implant is an integral part of breast augmentation surgery, it is not the device alone that determines the ultimate result.  A beautiful, safe augmented breast is determined by HOW the breast implant device is used.

 

About the Author: Terrye Tebbetts is one of the most knowledgeable women in the world about breast implants, with 27 years of experience educating patients and 11 years as a patient herself. For more information about breast implants or breast augmentation Dallas surgeons, please visit www.thebestbreast

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