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Dr. Linder's Blog

BREAST SURGERY CONSULTATION

Posted On: November 15, 2011 Author: The Office of Dr. Stuart Linder Posted In: Home, Plastic Surgery

Beverly Hills

Patients present to us in greater numbers for consultation, for breast augmentation, breast revision, breast lift, breast reduction, tummy tuck and lipocontouring.  With respect to your breast augmentation or breast revision consultation, it is important that the patient first of all seek a Board Certified Plastic and Reconstructive Surgeon, a Diplomate of the American Board of Plastic Surgery, whenever considering breast surgery.  There are no substitutes for a Board Certified Plastic and Reconstructive Surgeon for any form of breast cosmetic or reconstructive surgery.  Furthermore, a specialist who operates on the breast ever week may be obtained in order to aid you towards your reconstructive or primary augmentation needs. 

 During consultation, it is important that the patient fully evaluated by a Board Certified Plastic Surgeon and not a consultant.  It is vital that the patient be comfortable with the doctor as well as with the doctor’s ability to take care of her plastic surgical needs and if a complication should arise the doctor should be able to correct problem.  As a result, your plastic surgeon should have tending privileges at a well respected hospital within five miles of his or surgery center.  During your consultation, bring a note pad and questions already set to ask the doctor so that you will not forget them during the consultation.  At the beginning of the consultation the doctor should get a quick medical history which should include age, number of pregnancies, family history of breast cancer, smoking history, past medical history, allergy to medication history as well as past surgery or medical conditions.  Preoperative mammogram should be evaluated if necessary.  After this, the doctor should ask subjective questions to the patient as to what her goals are in terms of size, shape, volume, etc.  A formal evaluation will now be performed in the examination room, evaluating the patient’s breasts, inframammary fold distances, as well as discrepancy of the chest wall, including abnormalities and deformities, including pectus excavatum, carinatum or other sternal deformities.  Asymmetries should be noted and marked as well.  Thickness of the muscle, amount of body fat versus glandular tissue will be identified. 

Next, the patient should look at many before and after pictures with the plastic surgeon showing what she likes and what she does not like.  The implants can then be looked at, silicone versus saline, looking at the profiles of low moderate, moderate plus, high profiles or extra high profile gels versus the saline high profile Allergan implants.  Pros and cons of each type of implant should be discussed and at this time a size determinant of the implant and silicone versus saline should be made.  Finally, risks and complications should be discussed, including, infection, scar tissue and rupture and deflation of implants.  The need for MRIs should also be discussed every two to three years with silicone implants. 

Any further questions from the patient can now be given and then the patients will be sat down with a consultant for scheduling and price issues.  It is vital that the patient ask questions regarding the surgery center and its certification as well as the anesthesiologist being Board Certified.  During our consultations we have streamlined them to allow patients to go through this process in approximately 30 to 45 minutes.