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Note: ASAPS cannot give advice about specific medical problems nor should answers provided by responding surgeons be substituted for a complete medical history, work-up and an in-personal medical/surgical consultation. Sorry we can't answer all questions. We try to select questions that have the widest general interest.
Picking breast implant size
There are several ways to select implant size, and none of them are perfect. However, the patient's preference needs to be taken into account. There are certain anatomical constraints that must also be considered, especially the base diameter of the breast. A well-trained nurse can be perfectly capable of taking the primary role in helping select the size, based on the working relationship with the surgeon. In our office, I take the measurements and discuss the appropriate size range, and the nurse then works with the patient trying on different sizes to make the final decision.
During your consultation, the your doctor will evaluate your breast tissue characteristics and measure the dimensions of ofofthe breasts. From this analysis the physician will make a recommendation on implant size. In my practice the patients input is welcomed and used in making a final decision. In addition I have the patient try on a range on implant sizes that are appropriate for their dimensions. In your case, I would seek a second opinion.
In many instances, the plastic surgeon may be in the room at the time of measurements and then leave to allow time for the sizing process with knowledgeable and experienced staff members who are familiar with the sizing process. Although, it may appear that the surgeon is not involved in the decision making process, the staff quite commonly will discuss the appropriate sizes outside of the patient's room to confirm the choice of size or to ask for additional input or advice. If at anytime, you would prefer to review this with the surgeon, it is always an option available to you.
I believe the surgeon should be the one doing the measurement and the sizing and the examination for proper choice of the implant. position of the implant, and the incision used. There should be discussion on risks and complications. The expected results and financial obligations if another or revisional surgery is needed.
Every practitioner is different. Most want to be involved with the decision making process of their patients. But, we a fast food society and expeditious delivery of services is often a priority over the quality of the product. Perhaps you should consider another evaluation by one of the many members of the ASAPS. Best,
Gary R Culbertson, MD, FACS