When New Is Not Better

I have been seeing lately that there is a “new” method of breast augmentation being promoted by non plastic surgeons. They call it “awake breast augmentation” because the patient is awake and under a light local anesthetic.

Supposedly, the awake patient can pick her size while on the operating room table. This shockingly ridiculous method is wrong on many levels. First of all, breast augmentation can be done with out intubation and general anesthesia. The first 1000 or so that I did were done that way. The patient, however, had IV sedation so that she would have no recall of adverse pain and would be comfortable and not anxious.

The use of sizers intra-operatively is hardly ever necessary. The decision of what size the patient can be is dictated by the pre-operative size of the chest wall, the compliance of the breast, the amount of overlying breast tissue and the desires of the patient. Today, using 3D imaging techniques, we have in our office, the size, brand, shape and type of implants can be visualized on the patients body while they are awake and have no medications on board to dull the senses.

Having the patient awake so she can see the result is unnecessary. I’m sure some of the impetus to do this outside of a sanctioned operating room is for cost savings and these docs, without proper surgical training, could probably not gain privileges in accredited operating rooms. Like anything in life, you get what you pay for. There are no shortcuts when it comes to safely, intelligently and skillfully performing an invasive procedure like breast augmentation. So don’t be fooled by impostors. If the doctor has not trained in plastic surgery, you surely can ask where his or her skill has been obtained and has any governing body in medicine scrutinized his or her cases to authenticate their abilities. (Board Certification) If he or she has not trained in a surgical specialty, I recommend looking elsewhere.

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