The Effect of Patient Involvement in Implant Size Selection on Satisfaction With Breast Size: An Analysis of 1,840 Primary Augmentations.

Background: Aesthetic breast surgery is a specific field, in which the aim is not to achieve any universally defined standard, but to meet the patient's expectations.

Objectives: The aim of the study was to determine the proportion of women who were dissatisfied with breast size following primary breast augmentation and decided for revision. The study presents and verifies an algorithm for breast implant selection which involves the patient in the decision-making process.

Methods: A retrospective analysis was performed of medical charts from January 2012 to December 2022 from one private center. The final analysis included 1840 patients. All had implants chosen according to the Patient Decision-Making Process on Implant Size Selection (PIS).

Results: Of the studied cases, 18 decided for implant exchange due to dissatisfaction with breast size (0.98%). This group differed significantly from the controls (n=1822) in the following aspects: lower BMI during primary procedure, lower mean implant volume and shorter follow-up. In all but two women, mean BMI increased by 1 unit before revisional surgery (from 19.7 to 20.6).

Conclusions: Dissatisfaction with breast implant size is a rare cause of revision in breast augmentation surgery when the patient is involved in the final decision on the volume of the implants. The presented algorithm (PIS) yielded less than 1% dissatisfaction with breast size in a long-term follow-up.