Patient Expectations After Breast Augmentation: The Imperative to Audit Your Sizing System

Patient dissatisfaction with breast size after breast implant surgery can lead to early secondary procedures in a minority of cases. Different systems of sizing a patient preoperatively have been proposed, including detailed measurements and computer-assisted assessment. Whatever system is used, a surgeon needs to obtain feedback to ascertain that the system is effective at producing a satisfactory outcome. In this study, 137 patients who underwent breast augmentation by a single surgeon were prospectively assessed for a 12-week period after surgery to determine their satisfaction with their breast size. Both expectations and desire to change implant size were assessed. Early (week 1) expectations of the patients were a good predictor of their long-term assessment 12 weeks after surgery and their desire to change their implant size. The patients with a greater body mass index (BMI) and larger implant volume were more likely to express a desire for a change in implant size early in the postoperative course. The findings showed that 19.4 % (26/134) of the patients wished to have larger implants by 12 weeks after surgery and that 3.7 % (5/134) felt smaller implants would be preferable. The information produced by this audit is important to the provision of future informed consent for this surgeon. Without similar data from their individual practices, surgeons cannot provide patients with an accurate assessment of their satisfaction after breast augmentation surgery. A similar undertaking is strongly recommended for surgeons performing breast implant surgery.

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