by Terrye Tebbetts
The most debated subjects in breast augmentation and breast implants are, for the most part, how to determine the implant size and pocket location. I think most patients assume that they just don’t know much about this from a medical stand point, only what they think they want, and will often go with what a friend did or the first thing a surgeon recommends. The true best answers for you to these two questions lie in the measurements of your own body. You have the power to determine which is clinically best for you – then you can listen to a surgeons opinion or a friend’s experience but you have to know what your body is calling for first!
In Dr. Tebbetts’ practice we make decisions about the pocket location based on how much tissue you have in the upper portion of the breast – if you have less than 2 cm of pinch thickness, then it is really better to put more of you – more soft tissue coverage over the implant. With newer techniques, Dual Plane punlished by Dr. Tebbetts in 2001, http://www.thebestbreast.com/news/downloads/pubs/04DualPlaneAugmentationPRSApril2001.pdf, the best breast augmentation surgeons can place the implant partially subpectoral and you can still be up and out to dinner that night taking Ibuprofen only. I hate to see patients choose overs because they are looking for a better recovery, when it might not be the correct pocket location for them. There are improved surgical techniques that can give you the coverage and the easier, less painful recovery – please be sure to ask you ps about those options when you go in for your next visit.
As for size, please, if you are looking for a natural look as you said in your initial post, please let your body – your own breast measurements – factor into the operative planning and implant size selection. I know you may like the look of a 350 when it is stuffed into your bra cup, but will your breast envelope allow that much volume? In other words, have you been much bigger maybe with a pregnancy? When you base the implant selection off of the High Five System – you are simply filling the empty space in the breast. For example, if you were a B, then went to a Full C/D at the height of pregnancy or nursing, then filling the empty space with an implant will probably take you back to what you were stretched to before. However, if you have never had much of a change in your breast size and you are using the implant to PUSH tissue to places it has never been, if done in excess, might cause some serious post op complications (rippling, edge visibility, bottomin out). So the fabric in your bra might stretch and handle a 350 well, but will your breast envelope? Maybe that is what your surgeon was struggling with – your desire for the 350 but also your desire to achieve a natural appearance.
By working with your surgeon to allow your body and tissue and measurements to help determine the pocket location and the size, you are giving yourself the very best chance of getting a really good result that will last a long time for you. Every woman who contemplates breast implants has to wrestle with reconciling what they want with what they can safely have – - afterall if you are going to do this, you want to get what you have been dreaming about and hoping for, but you also want to have the least risk of reoperation and revision long term. There is no right or wrong in your two questions – over vs under and size – - just what is right for your body.
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.