Saturday, February 25, 2006

How big is too big? Breast implants and size

I was browsing some of the breast-implant related sites Implants411, implantinfo,
Yes, They're fake!, etc... this past weekend and had a few thoughts.

What's being played out to me on many of these bulletin boards is some poor educational efforts by the surgeons these women are consulting with. I'm really taken aback by the size and location (subglandular position) that many of the participants in those forums are reporting that they've had done or been recomended to have done. What I don't think is being adequately represented to these women are the long-term consequences of large implants on their tissue. 5' 6" 120 lb women do NOT need 500cc implants and that just appears to be too common a reported scenario.

Predictably what we (Plastic Surgeons) are going to be creating is an attenuated skin envelope with potentially irreversible or difficult to correct deformities. This is the nexus of patient's obsession with size colliding with a cosmetic surgeons desire not to alienate a potential client. The debate about which master we serve with breast augmentaion- the patient's desire or the patient's best interest is a debate that has generated a lot of controversy. There was a particular nasty spat in the letters column of
Plastic & Reconstructive Surgery (our flagship journal)last year on this topic with alternating charges of wrecklessness versus (allegedly) paternalistic attitudes towards patients.

Having done a fellowship in breast surgery heavy in revisional surgeries, I'm more and more convinced that we (as a specialty) deserve an F (or a least a DD :) )on our communications in this area.


Anonymous said...

Thank you for your voice of reason!
I have had numerous revisional surgeries due to complications (capsular contracture and lastly symmastia) I'm 5'10" 139 lbs with very little natural breast tissue. I had a modest implant of 400cc which took me to a 34D, yet I still had all these problems.

I read forums where 5 foot nothing gals weighing 97 lbs are getting 500-600 cc implants and they go back for more!!! The one phrase I've learn to deplore is 'booby greed'. I just don't understand the PS who willing put larger and larger implants into these people!

tobasco said...

I had breast implants and asked for a full B cup. I was give DD cups. I am 55 years old, 5'1" tall, and weigh 108. I have a small frame. I had a revision was he gave me D cups. Why would a surgeon do this to someone? I am now going to a new surgeon for a revision. This has been a very negative experience.

Dr. Rob Oliver said...

Discrepencies as you describe sound like a total lack of communication between you and your surgeon.

A person of your frame would likely be best served with implants between 250-325cc depending upon the width of your breast

Anonymous said...

I am a 53 year old woman, who has had numberous surgeries because of breast implants. The surgeries have been to correct capsular contracture, and symmastia. I am 5'6" and weigh 118 lbs. The surgeon who has done MOST of the operations, put in 350 cc implants, which my new surgeon feels are too large for my frame. I agree!

I am planning to have smaller implants...maybe 275 or 300 cc's, and at the same time correct yet another capsular contracture of the right breast.

I am wondering if I will need to have a breast lift done at the same time?

I honestly wish I had never had such large implants, but I had no knowledge of "choosing". I simply trusted the surgeon.

big breast surgery said...

hello what will happen if you inplant exceed to its maximum? is there a complication?
thanks very much - samantha