A decision-making method for breast augmentation based on 25 years of practice

Introduction Breast augmentation is the most commonly performed procedure in the field of aesthetic plastic surgery [1,2]. Women considering breast enhancement are mostly interested in shape improvement: 29% wish to improve the size or volume of their breasts, 15% wish to improve the general shape, 29% wish to return to a previous shape (pre-breastfeeding), 32% would like to address sagging of their breasts, and 8% wish to improve symmetry. Accurate preoperative planning is crucial for obtaining the best outcomes and for reducing the re-intervention rate. The entire decisionmaking process in breast augmentation was initially determined exclusively by the patient’s wishes and the surgeon’s preferences, making the choice of implant size, type of implant, implant position, and type of incision an arbitrary decision. This led to high re-intervention rates due to patients’ dissatisfaction with the implant size and other postoperative complications [3-5]. Many techniques aiming to refine the preoperative decision-making process for breast augmentation have been developed in the last 10 years, leading to a significant reduction of the re-operation rates [6-8]. Lower re-intervention rates are associated with the application of tissue-based planning methods and decision-making systems matching implants to patients’ tissues and breast dimensions [912]. Herein, we present our planning method, which is derived from more than 25 years of experience in aesthetic breast surgery and COMMUNICATION