Once a patient has demonstrated to me what their ideal breast appearance is (by picking their favorite patient photos on my website), I check to make sure that the photos they selected are relatively realistic comparisons for that given patient. If the comparison is fairly unrealistic, I will keep the “ideal” in mind, but also direct them to more realistic comparison photos. Everyone has unique features to their breasts that will carry over to their result after breast augmentation, but seeing a patient’s ideal certainly helps me focus in on their preferences with regard to size, proportion, upper breast fullness, breast width and cleavage.
I also generally ask my breast augmentation patients in Phoenix whether they are more worried about being too big or too small, so I will know which way to lean once I am within their target size range. Most patients prefer to lean towards the somewhat fuller side of their preference range; however some patients are much more interested in maintaining a smaller overall breast size.
In addition to a patient’s desires, it is also important to match an implant appropriately to their tissue parameters. In other words, the implants must fit the proper width of their breasts and not exceed the capacity of the tissues and skin to support the implants. This is where my judgment and experience as a surgeon come in, and I guide patients to a choice that will both meet their initial goals and hold up well over time.
When I am in the operating room, I create the appropriate sized breast pockets in each patient, taking care to maintain as natural and smooth a space for the implants as possible. After the first pocket is created, I place a sizer (which is a replica of the final implant) into the patient’s breast pocket. Which size and profile sizer I pick initially will be based on the patient’s preoperative size and shape wishes, their tissue parameters, and my experience to give them the best overall result. Once the sizer is in place, I examine the patient both lying down and with the operating table in the seated position (with the patient still asleep) in order to assess the implants size, position and contour. I will then try some other sizers while comparing the patient to their preselected photos to ensure that the final implant choice is the best I can provide for that patient.
Since I have my own operating room, I have a full range of implant shapes and profiles with the corresponding sizers, so I never have to guess whether an implant will look right. I can see exactly how it looks using the sizer before I open the final implant. Once I finish sizing one breast, I do the same for the opposite breast to ensure the best possible symmetry. Many surgeons don’t use sizers, because it does add some time to the surgery. For me, the extra time is worth it for a more aesthetic and precise result. As I explain to patients: you probably wouldn’t buy a pair of shoes without trying them on, so if I am placing implants in your body for potentially 10 to 15 years, I like to test it out the fit on them too!