Key Insights From a Decade of Breast Augmentation: Our 5 Critical Decisions in Breast Implant Selection
Breast augmentation continues to rank among the most commonly performed procedures. A crucial factor in achieving successful outcomes lies in a methodical implant-selection system, a principle underscored by Tebbetts and Adams in their TEPID and High Five systems. We have revisited several factors d...
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| Vydané v: | Plastic and reconstructive surgery. Global open Ročník 13; číslo 4; s. e6695 |
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| Hlavní autori: | , |
| Médium: | Journal Article |
| Jazyk: | English |
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United States
Lippincott Williams & Wilkins
01.04.2025
Wolters Kluwer |
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| ISSN: | 2169-7574, 2169-7574 |
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| Abstract | Breast augmentation continues to rank among the most commonly performed procedures. A crucial factor in achieving successful outcomes lies in a methodical implant-selection system, a principle underscored by Tebbetts and Adams in their TEPID and High Five systems. We have revisited several factors during years of experience.
Thorough preoperative consultations play a pivotal role, involving discussions on the patient's motivation for breast augmentation and their medical history. Subsequently, medical photographs are taken, and 5 critical breast measurements are recorded: sternal notch-nipple distance, base width of the breast, soft-tissue coverage of the implant, optimal implant selection based on volume and dimensions, and calculation of the neo-inframammary fold using the Pythagorean theorem. Our system goes beyond traditional approaches by offering patients the chance to preview the postoperative result through both bra sizers and 3-dimensional simulation. Shared decision-making is another integral aspect of our methodology, providing patients with a voice in the medical decision-making process.
During the period from 2009 to 2019, the senior author conducted primary breast augmentations on 716 patients, with follow-ups extending up to 3 years. Notably, 1.5% (11 patients) required reoperation, and only 0.03% (2 patients) underwent reoperation specifically for implant size exchange.
Our system's strength lies in its reliance on straightforward tissue-based measurements and a commitment to incorporating patient preferences through interactive decision-making. We aim to contribute to the professional development of fellow plastic surgeons and residents by sharing our 5 critical decisions, confident in their potential value for enhancing their practice. |
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| AbstractList | Breast augmentation continues to rank among the most commonly performed procedures. A crucial factor in achieving successful outcomes lies in a methodical implant-selection system, a principle underscored by Tebbetts and Adams in their TEPID and High Five systems. We have revisited several factors during years of experience.
Thorough preoperative consultations play a pivotal role, involving discussions on the patient's motivation for breast augmentation and their medical history. Subsequently, medical photographs are taken, and 5 critical breast measurements are recorded: sternal notch-nipple distance, base width of the breast, soft-tissue coverage of the implant, optimal implant selection based on volume and dimensions, and calculation of the neo-inframammary fold using the Pythagorean theorem. Our system goes beyond traditional approaches by offering patients the chance to preview the postoperative result through both bra sizers and 3-dimensional simulation. Shared decision-making is another integral aspect of our methodology, providing patients with a voice in the medical decision-making process.
During the period from 2009 to 2019, the senior author conducted primary breast augmentations on 716 patients, with follow-ups extending up to 3 years. Notably, 1.5% (11 patients) required reoperation, and only 0.03% (2 patients) underwent reoperation specifically for implant size exchange.
Our system's strength lies in its reliance on straightforward tissue-based measurements and a commitment to incorporating patient preferences through interactive decision-making. We aim to contribute to the professional development of fellow plastic surgeons and residents by sharing our 5 critical decisions, confident in their potential value for enhancing their practice. Background:. Breast augmentation continues to rank among the most commonly performed procedures. A crucial factor in achieving successful outcomes lies in a methodical implant-selection system, a principle underscored by Tebbetts and Adams in their TEPID and High Five systems. We have revisited several factors during years of experience. Methods:. Thorough preoperative consultations play a pivotal role, involving discussions on the patient’s motivation for breast augmentation and their medical history. Subsequently, medical photographs are taken, and 5 critical breast measurements are recorded: sternal notch–nipple distance, base width of the breast, soft-tissue coverage of the implant, optimal implant selection based on volume and dimensions, and calculation of the neo-inframammary fold using the Pythagorean theorem. Our system goes beyond traditional approaches by offering patients the chance to preview the postoperative result through both bra sizers and 3-dimensional simulation. Shared decision-making is another integral aspect of our methodology, providing patients with a voice in the medical decision-making process. Results:. During the period from 2009 to 2019, the senior author conducted primary breast augmentations on 716 patients, with follow-ups extending up to 3 years. Notably, 1.5% (11 patients) required reoperation, and only 0.03% (2 patients) underwent reoperation specifically for implant size exchange. Conclusions:. Our system’s strength lies in its reliance on straightforward tissue-based measurements and a commitment to incorporating patient preferences through interactive decision-making. We aim to contribute to the professional development of fellow plastic surgeons and residents by sharing our 5 critical decisions, confident in their potential value for enhancing their practice. Breast augmentation continues to rank among the most commonly performed procedures. A crucial factor in achieving successful outcomes lies in a methodical implant-selection system, a principle underscored by Tebbetts and Adams in their TEPID and High Five systems. We have revisited several factors during years of experience.BackgroundBreast augmentation continues to rank among the most commonly performed procedures. A crucial factor in achieving successful outcomes lies in a methodical implant-selection system, a principle underscored by Tebbetts and Adams in their TEPID and High Five systems. We have revisited several factors during years of experience.Thorough preoperative consultations play a pivotal role, involving discussions on the patient's motivation for breast augmentation and their medical history. Subsequently, medical photographs are taken, and 5 critical breast measurements are recorded: sternal notch-nipple distance, base width of the breast, soft-tissue coverage of the implant, optimal implant selection based on volume and dimensions, and calculation of the neo-inframammary fold using the Pythagorean theorem. Our system goes beyond traditional approaches by offering patients the chance to preview the postoperative result through both bra sizers and 3-dimensional simulation. Shared decision-making is another integral aspect of our methodology, providing patients with a voice in the medical decision-making process.MethodsThorough preoperative consultations play a pivotal role, involving discussions on the patient's motivation for breast augmentation and their medical history. Subsequently, medical photographs are taken, and 5 critical breast measurements are recorded: sternal notch-nipple distance, base width of the breast, soft-tissue coverage of the implant, optimal implant selection based on volume and dimensions, and calculation of the neo-inframammary fold using the Pythagorean theorem. Our system goes beyond traditional approaches by offering patients the chance to preview the postoperative result through both bra sizers and 3-dimensional simulation. Shared decision-making is another integral aspect of our methodology, providing patients with a voice in the medical decision-making process.During the period from 2009 to 2019, the senior author conducted primary breast augmentations on 716 patients, with follow-ups extending up to 3 years. Notably, 1.5% (11 patients) required reoperation, and only 0.03% (2 patients) underwent reoperation specifically for implant size exchange.ResultsDuring the period from 2009 to 2019, the senior author conducted primary breast augmentations on 716 patients, with follow-ups extending up to 3 years. Notably, 1.5% (11 patients) required reoperation, and only 0.03% (2 patients) underwent reoperation specifically for implant size exchange.Our system's strength lies in its reliance on straightforward tissue-based measurements and a commitment to incorporating patient preferences through interactive decision-making. We aim to contribute to the professional development of fellow plastic surgeons and residents by sharing our 5 critical decisions, confident in their potential value for enhancing their practice.ConclusionsOur system's strength lies in its reliance on straightforward tissue-based measurements and a commitment to incorporating patient preferences through interactive decision-making. We aim to contribute to the professional development of fellow plastic surgeons and residents by sharing our 5 critical decisions, confident in their potential value for enhancing their practice. |
| Author | van der Lei, Berend Bletsis, Patrick P. |
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| Copyright | Copyright © 2025 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. Copyright © 2025 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. 2025 |
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| References | Bletsis (R2-20250414) 2023; 43 Bouwer (R7-20250414) 2015; 135 Adams (R3-20250414) 2016; 138 Charles (R8-20250414) 1997; 44 Hidalgo (R12-20250414) 2010; 125 Adams (R9-20250414) 2008; 122 Mallucci (R10-20250414) 2016; 137 Tebbetts (R4-20250414) 2006; 118 Bletsis (R6-20250414) 2018; 71 Tebbetts (R5-20250414) 2002; 109 Tebbetts (R11-20250414) 2011; 127 |
| References_xml | – volume: 43 start-page: NP595 year: 2023 ident: R2-20250414 article-title: The influence of BIA-ALCL on the use of textured breast implant and its placement: a survey of Dutch plastic surgeons. publication-title: Aesthet Surg J doi: 10.1093/asj/sjad067 – volume: 135 start-page: 110 year: 2015 ident: R7-20250414 article-title: The Pythagorean theorem as a tool for preoperative planning of a concealed scar in augmentation mammaplasty with round implants. publication-title: Plast Reconstr Surg doi: 10.1097/PRS.0000000000000775 – volume: 44 start-page: 681 year: 1997 ident: R8-20250414 article-title: Shared decision-making in the medical encounter: what does it mean? (or it takes at least two to tango). publication-title: Soc Sci Med doi: 10.1016/S0277-9536(96)00221-3 – volume: 137 start-page: 1728 year: 2016 ident: R10-20250414 article-title: Design for natural breast augmentation: the ICE principle. publication-title: Plast Reconstr Surg doi: 10.1097/PRS.0000000000002230 – volume: 122 start-page: 1892 year: 2008 ident: R9-20250414 article-title: The process of breast augmentation: four sequential steps for optimizing outcomes for patients. publication-title: Plast Reconstr Surg doi: 10.1097/PRS.0b013e31818d20ec – volume: 138 start-page: 987 year: 2016 ident: R3-20250414 article-title: Matching the implant to the breast: a systematic review of implant size selection systems for breast augmentation. publication-title: Plast Reconstr Surg doi: 10.1097/PRS.0000000000002623 – volume: 127 start-page: 1001 year: 2011 ident: R11-20250414 article-title: Bra stuffing for implant sizing? Satisfaction? Who, when, and compared to what? publication-title: Plast Reconstr Surg doi: 10.1097/PRS.0b013e318200abd0 – volume: 118 start-page: 35S year: 2006 ident: R4-20250414 article-title: Five critical decisions in breast augmentation using five measurements in 5 minutes: the high five decision support process. publication-title: Plast Reconstr Surg doi: 10.1097/01.prs.0000191163.19379.63 – volume: 109 start-page: 1396 year: 2002 ident: R5-20250414 article-title: A system for breast implant selection based on patient tissue characteristics and implant-soft tissue dynamics. publication-title: Plast Reconstr Surg doi: 10.1097/00006534-200204010-00030 – volume: 125 start-page: 1781 year: 2010 ident: R12-20250414 article-title: Preoperative sizing in breast augmentation. publication-title: Plast Reconstr Surg doi: 10.1097/PRS.0b013e3181cb6530 – volume: 71 start-page: 1116 year: 2018 ident: R6-20250414 article-title: Evaluation of anatomical and round breast implant aesthetics and preferences in Dutch young lay and plastic surgeon cohort. publication-title: J Plast Reconstr Aesthet Surg doi: 10.1016/j.bjps.2018.04.010 |
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