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
Hlavní autori: Bletsis, Patrick P., van der Lei, Berend
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: 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.
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.
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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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Snippet Breast augmentation continues to rank among the most commonly performed procedures. A crucial factor in achieving successful outcomes lies in a methodical...
Background:. Breast augmentation continues to rank among the most commonly performed procedures. A crucial factor in achieving successful outcomes lies in a...
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Title Key Insights From a Decade of Breast Augmentation: Our 5 Critical Decisions in Breast Implant Selection
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