Breast Implants: What looks good on paper, may not be best for you

Question ~

I have read your book, The Best Breast 2, which was very informative and insightful. I have been trying to locate knowledgeable, experienced plastic surgeons based on your recommendations in the book. I have not been able to locate any surgeons in the 410 study in the Mississippi area that are willing to place this type implant in a 1st time BA patient who is healthy, and thin (like myself) that is just trying to achieve natural shaped breasts. I have been told by several other patients of yours that you have a list of all the surgeons participating in the studies (Care & Core) and might be able to assist in finding a surgeon in my area.

In the mean time I have spoken to several other surgeons who aren't participating in the study but that are experienced in placing anatomic implants. One of them being Dr. X, who claims to know you. I wanted to check to see if this was true and if you had feedback to give me on what your opinions were of his augmentations/practice/philosophy.

Thanks for your time... and I'm extremely thankful that you have provided such a wonderful tool for augmentation patients!

Answer ~

I am so glad you have read the book!  I have been following some of your posts on the forum and did not respond because the other ladies did such a good job explaining things.  But I am glad you wrote to me because I really want to be sure you understand two very important concepts. 

1.   What makes a breast look pretty and natural is NOT the implant, but how the implant is used.  Think really carefully about what I just wrote and it will start to make sense to you.  Even the most “natural” implant, whatever implant each patient has decided is the best for them, if it is too BIG for you, then there will be no room for all the volume and it will bulge in the upper breast and look fake.  This is why planning your operation based on clinical, objective measurements – using High Five – is so important.  If High Five chose the implant size, it will never be too big or too small.  It is what the empty space in the breast needed and has been scientifically proven to be the best way to reduce your risk of reoperation long term.  So the size and how the implant is used is more important to your overall end result than the type of implant.

2.  No implant is perfect – they all have pros and cons.  So what may seem like the “perfect” implant on paper, maybe a disaster for you if you are not a good candidate for it’s “cons”.  Dr. Tebbetts has gone on record from the very beginning of these anatomic products saying that not everyone is a good candidate for them and that patients and surgeons should be very careful in their patient selection criteria.  So, if you are very thin, or have a large, wide pocket, or are a borderline lift, or has very stretchy tissue or are a redo/revision etc you may not be a good candidate for a shaped implant.

You have to remember that Dr. Tebbetts speaks at lots of meetings and venues and has a book for surgeons (in addition to TBB2) about how to do BA – so a lot of ps know of him and the work he has published, but we do not personally know the surgeon you mentioned and therefore cannot recommend him or his work because we do not have personal knowledge of his practice.  You know how to figure out if he really uses High Five and can produce a 24 Hour Recovery though because of the book – so ask the hard questions.  There should be no imaging or sizers used to decide size – the formula should be worked out in front of you at consult.  Ask about breast augmentation recovery – because there should be no bras, bandages, drains, bruising, narcotics and no restriction of normal movement the afternoon of surgery.  Our patients routinely are up and moving and shopping or going to soccer games the night of their surgeries.  And the best thing we have learned about 24 Hour is that it has been proven to reduce patients risk of capsular contracture (our rate is 1.5%).

I hope this helps you and I am happy to work through any more questions you may have!