In breast augmentation patients wish to obtain the best results possible. Patients often rely on the surgeon to obtain this result and surgeons often consider breast augmentation to be a simple procedure, concentrating on the size that patients wish for. With many different options available and patients becoming more informed the focus now has shifted to preoperative planning so that patients can understand the pros and cons of the various implant options. With different shaped implants there is now more of a focus on the ideal shaped result.
Many plastic surgeons utilize breast implant sizers in breast augmentation surgery to estimate the ideal implant volume and shape after creating the surgical pocket. A sizer is a device that mimics the permanent implant and come in different sizes and shapes.
Intraoperative breast sizers may be a valuable tool in a training program to allow the novice surgeon to visualize and dissect an accurate breast pocket. However, the routine usage of implant sizers may cause tissue trauma, augment contamination risks, and increase intraoperative time and may also be expensive. It does not allow the patient to be involved in the decision making process.
A recent study from Brazil, courtesy of the senior Author Ivo Pitanguy, has shown that the complications of infection, seroma, hematoma, and capsular contracture when using sizers were correlated with a higher complication rate.
The authors recommend that surgeons spend more time preoperatively planning the operation. The bio-dimensional planning preoperatively can provide a suitable alternative for the inexperienced surgeon.
Mr. Ross uses bio-dimensional analysis in all his breast augmentation procedures. By using detailed measurements preoperatively, patients can be taken through the various implant options and be empowered to choose the correct implants for them. Mr. Ross does not use implant sizers and decisions regarding breast augmentation are always made preoperatively with the patient.
In experienced hands any advantage of implant sizers are outweighed by the increased complications. Furthermore Mr. Ross believes that a change to the preoperative plan following the use of breast sizers may not be in the patient’s best interest. Patients are not involved in this decision making process and Mr. Ross would rather spend longer preoperatively with the patient to guide patients to be empowered.
Using bio-dimensional analysis helps patients to understand not just the size that can be achieved / expected but also provide more of a focus on the shape that can be achieved / expected.
Reference
Khoo LS, Radwanski HN, Senna-Fernandes V, Antônio NN, Fellet LL, Pitanguy I. Does the Use of Intraoperative Breast Sizers Increase Complication Rates in Primary Breast Augmentation? A Retrospective Analysis of 416 Consecutive Cases in a Single Institution. Plast Surg Int. 2016;2016:6584810.
