Current Concepts in Breast Augmentation – What is the Best Way?

I recently posted some ideas of mine having done breast augs for upwards of 37 years.  There was a very interesting article that was a capsule summary of a questionnaire answered by 1067 plastic surgeons.  So I thought you all might be interested in the results.

Almost 52% of surgeons DO NOT use anatomical implants.  I do not due to cost in some cases and the potential for mal-rotation.  Post op massage is popular with the majority of surgeons and I for one believe in it.  Most surgeons use smooth implants and 83.9% of the surgeons surveyed used the inframammary approach.  Axillary was preferred by only 3.3%of the surgeons.  Almost 80% believed partial sub muscular pockets versus 5.4 who prefer sub glandular.  Depending on the amount of soft tissue I prefer sub glandular.  I think it gives a more natural look and for sure a much easier recovery.  Most surgeons me included use IV antibiotics prior to surgery.  Most surgeons allow normal activities from 4-6 weeks.  I usually allow patients to return to normal activities around 4 weeks.  The vast majority of implants – 90% are silicone.  Once a capsule forms, about 36% of surgeons may try pharmaceutical agents .  I have tried them on occasion with limited success.  Regarding the use of a patient’s own fat for augmentation less than 20% currently offer this to their patients.  A lot in my opinion, depending on the availability of donor sites.  I use this technique quite often to enhance the aesthetics of my breast augs by placing fat ABOVE and MEDIAL to the implant.  I call this a composite aug.  Great procedure…..great technique.

In the end I would say that each individual surgeon should do what he or she does best.  There is no right way.  It is a collection of each individual surgeons collective year of experience.  For sure my experience has altered what I do today versus 20 years ago.  Surgical art and skills are in a constant state of flux.

Dr. Brueck

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