Explaned Breast implant selection by individual. Why is it important?

Choosing the right implant size for breast augmentation is a critical decision that significantly impacts the outcome of the procedure. While patients often have a desired look in mind, the final decision on implant volume should be a collaborative process between the patient and surgeon, guided by objective measurements and tissue-based planning.

John Tebbetts’ “Five Critical Decisions in Breast Augmentation” emphasizes the importance of using quantitative measurements to guide implant selection, rather than relying solely on patient preference. This approach, known as the High Five decision support process, prioritizes five key decisions based on five critical measurements.

The process involves assessing:

1. Tissue characteristics
2. Breast and chest wall dimensions
3. Implant dimensions relative to breast dimensions
4. Implant volume
5. Implant pocket position

While a woman can express her desired outcome, the final implant volume decision should be based on these objective measurements to ensure the best possible results and reduce the risk of complications or reoperations.

Studies using this tissue-based planning approach have shown significantly lower reoperation rates. In a study of 1,664 cases with up to 7 years of follow-up, the overall reoperation rate was just 3%, with only 0.2% of cases requiring implant size exchange.

It’s important to note that implant size is measured in cubic centimeters (cc) rather than cup sizes. The appropriate implant size depends on various factors, including:

• Body proportions
• Chest width
• Existing breast tissue
• Skin elasticity
• Patient’s lifestyle and activity level

While a patient may have a specific size in mind, the surgeon must consider these factors to recommend an implant volume that will achieve the desired aesthetic outcome while minimizing risks and ensuring long-term satisfaction.

In conclusion, while a woman can and should communicate her desired outcome, the final decision on implant volume should be guided by objective measurements and the surgeon’s expertise. This approach, as advocated by Tebbetts, leads to better outcomes, lower reoperation rates, and higher patient satisfaction in the long term.