by Terrye Tebbetts

I want to be sure to clarify what I have said about size and volume issues recently.    In order for a breast to be pretty – it has to be FULL.  So whatever it takes to fill it, it needs.  When a clinical measurement system is involved – then there are limits – parameters……for example – one measurement that is always key is Nipple to Inframammary fold distance under stretch – - if it is 9.5 cm or more, then this breast is most likely a good candidate for a lift rather than an implant.  Ahh, but then stretch has to factor in – so if she has very little stetch (less than 2 cm) – she could get away with just an implant – understanding that it will fill from the bottom up resulting in a very pretty, natural breast but not a high perky one (see result on page 490 of TBB2).

What about base width – to think about using a 400 cc implant, according to High Five, the patient must start with a base width of 15 cm – - think about that – 15 cm wide.  In order not to see edges of an implant there has to be at least .5 cm on each side – so we are talking a minimum of 16 cm widths to even talk 400cc.  Now if a patient has that measurement and N:IMF of less than 9.5 then perfect – 400cc’s it is – that is what that breast will need to fill it.

So it’s not about whether I think implants over 350 are rarely needed – - in our practice, if a patient needs 350 or more, we want to be sure, again, that she understands that that is a significant amount of weight and that she may need a lift in the future if we implant that today.

There are certainly patients whose measurements require larger implants – and turn out really pretty.  I would just like to see more of the decisions to get larger implants based on the parameters that the breast is handing the patient and the surgeon.  Not simply to try to reach a certain look or result that  – honestly – may not be attainable and might actually be harmful as in Patty’s story (and many others I’m sure).

Remember, a beautiful breast is not a pure result of how big it is.  As in most everything else in life, size is relative.  If the measurements call for it – it is what it needs – but pushing tissue in chase of the unattainable is not a smart idea 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.