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How to correctly choose an implant size? - Breast enlargement is the most popular cosmetic surgery procedure in the UK . The increasing popularity and accessibility of cosmetic surgery has seen a significantly increased demand for this operation. Despite this, very few patients truly understand the nature of the operation, the risks involved, the limitations of the surgery and the long-term effects. Although the past few years have seen a lot of media hype associated with the good effect of breast augmentation, the level of good information available is less than satisfactory.
However, an even more disturbing fact is that, due to lack of proper training, very few surgeons who are beginning their practice really understand the different factors and variables that are paramount in achieving a good, long term result. Everyone knows that a breast augmentation involves adding an implant onto a pre existing breast. However, relatively few surgeons and hardly any patients grasp the relationship of patient desire, expectations and the physical aspects of volume enlargement.
Cosmetic surgery is unique in that unlike other surgical specialties, it is performed in a five dimensional framework. To undertake any successful cosmetic surgery operation understanding of this framework is a basic requisite. Breast enlargement is no exception to this rule. By this we mean that there is three-dimensional framework of the (physical) body. In addition, a cosmetic surgeon has to take into account the fourth dimension of Time. This means that a cosmetic surgeon has to look into the future to visualise the desired final result after the healing process is complete, taking into account the physical characteristics that are unique to each individual. Even more importantly a cosmetic surgeon has to delve into the patient's mind and ascertain the nature what the patient dreams of and wants, what the patient desires and what the patient expects. Understanding this desire is fundamental to a successful cosmetic surgery operation. In performing breast augmentation, all these principals are illustrated beautifully.
In this article we shall endeavor to outline the basic parameters that a surgeon must take into account, based on the principles outlined above. In this respect, the most important element is understanding what a patient wants. Most patients try to describe their desired result in vaguely defined concepts and unquantifiable terms. In our experience, many female patients are even unaware of what a breast cup size means and how cup sizes are measured. Without this basic understanding achieving patient expectations may be impossible. Hence, the patient education, to make a patient understand her own desires and relate them to the limitations imposed by their own body and tissues is the most significant contributor towards a patient satisfaction.
For many surgeons and patients, proper implant selection is an art rather than a science. No single method has been proven to predict what size or shape will provide long-term patient satisfaction. With detailed patient education, discussion, and counseling and respect for implant-soft tissue dynamics the rate of dissatisfied patients can be reduced significantly. The goal of augmentation is to improve the size and the shape of breasts. And while this creates, a more positive self-image, the only predictable change is larger breasts. Positive psychological effects are common, but are not necessarily predictable.
At the beginning of each consultation, we enquire from the patient about two element of what they seek. First, why do they want breast enlargement and second, what do they want to achieve. Understanding the answer to the first gives a clearer picture of the motivation behind seeking surgery and makes it easy to root out excessive or wrong expectations and to filter out obsessive element the patient desire. The answer to the second question helps the surgeon to define and quantify the patient desire in physical and measurable terms.
Patients seeking breast augmentation fall into three broad categories:
- Young patients whose breasts have not grown to achieve 'normal fill'.
- Patients, mostly in their 30's who have suffered the effects of pregnancy related changes and changes related to weight fluctuations.
- Middle aged patients, late 40's onwards, who started with small breasts and have changed further due to ageing process.
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