There are many methods described by surgeons to select the breast implant for breast augmentation and determine the best outcome for patients.
In Mr Ross’s opinion the only person who can determine the optimal outcome is the patient. In order that patients can understand the pros and cons of the various options patients must be educated as to the many different options available to them. Through this decision-making process patients need to be given sufficient information to be able to be empowered to make the decision.
Mr Ross uses both tissue planning and dimensional analysis alongside 3D analysis and virtual reality technology to help patients. Education involves not only written information but also a series of detailed consultations to look through preop and postop photos of previous patients.
Mr Ross uses patient outcome related outcome measures and patient feedback to constantly analyse his results and this can also help guide patients through the decision making journey.
Where patients wishes are either not realistic or have the potential to do harm it is important that patients are educated as to the reasons why. There are often a range of implants and pockets in a range of sizes that patients can choose from and almost every implant and pocket selection will have some form of compromise. Variations in size and shape will all have implications in the longer term. Patients need to accept that the result is most importantly determined by their own anatomy and where expectations are deemed unrealistic the avoidance of surgery may be an outcome that needs to be discussed.
Recently Dr Adams has published a review of the various methods used by surgeons to help patients make these important decisions.
Measurements, sizing, tissue based and bio dimensional planning are all essential tools for both the surgeon and the patient. As described it is essential that surgeons continually audit and analyse their results in a consistent manner.
Mr Ross agrees with Dr Adams conclusion that the selection of the best implant for breast augmentation can only be determined by the detailed comparison of patient outcome measures and comparing these against the surgical related outcome measures.
Reference Adams WP Jr, Mckee D.Matching the Implant to the Breast: A Systematic Review of Implant Size Selection Systems for Breast Augmentation. Plast Reconstr Surg. 2016 Nov;138(5):987-994.
