Interview 26 December 2015
Dr. Greg Pataki plastic surgeon is the chief plastic surgeon of Premium Plastic Surgery in Budapest, where mostly aesthetic-reconstructive surgical operations are performed. Breast augmentation is part of the clinic’s daily routine, so Dr. Pataki knows a lot about the motivations of the patients. He answers some important questions concerning breast augmentation for the readers of a Hungarian magazine called SPORTIME below.
– Breast augmentation is one of the most common surgery in your clinic. It can be performed due to several reasons. What is the main motivation of the ladies who attend your clinic?
– As each woman has her own “ideal image” about beautiful, feminine breasts, the motivations of breast augmentation are different. Of course, the most common reason is that they want bigger breasts. Nowadays, in the Western culture a shapely bosom embodies feminity. If they are not satisfied with the gift of the nature, it can be perceived as demolition of their feminity, which reduces their confidence as well. Besides this, asymmetry and pregnancy-related changes are the major reasons.
– Is asymmetry that common? What is the solution?
– Many women turn to us because of similar complaints. Significant asymmetry of the breasts can be really disturbing, and mostly occurs in younger patients. We can call this a certain kind of malformation in medical sense. Almost every woman has asymmetrical breasts, but it is not always obvious. But if one breast is a whole cup size smaller than the other, that can mean psychological burden. With suitable implants – which have typically different shape and size –, very good results can be achieved. Implant-sizing and fitting are very important pillars of the first consultation.
– Pregnancy-related changes how affect women? What is the solution?
– The pregnancy is a blessing for many women, and figuratively meant “curse” alike; as the joy of having a baby is incomparable, but the physical strain leaves its heavy marks on their body. We can increase the lost volume by using implants, and in many cases, it solves the sagging as well. Breast-lift is often necessary too – for the best aesthetic result. Depending on the situation, we perform a simple breast-lift or complex breast tissue remodelling, such as an implant combined with a breast lift, which is one of the biggest challenges in plastic surgery. These breast enhancements can be part of the so called „mommy makeover” treatments, in which a tummy tuck or a facial rejuvenation may be included too.
– Breast augmentation is certainly not a result of an ad-hoc idea. What do you recommend for the best decision?
– Indeed, it is not advisable to make a spontaneous decision. Since it is a surgery, must be carefully considered. To ensure that patients do not repent of their decision, thorough preliminary consultation is needed. Choosing a plastic surgeon with many years of experience in aesthetic surgery and breast augmentation is important. Only certified plastic surgeons have all the necessary knowledge in this area. Their empathy, precision, patience and other qualities show during a personal consultation. A discussion with a plastic surgeon with years of experience can preview the expected outcome in some way, e.g. with implant-sizing tools, computer modeling, and before-after photos of other patients. It is crucial that the size and the shape have to be a joint decision. The patient should not determine the size in numbers (e.g. „My friend got 300 cc!”), and the surgeon should not have a „one-size-fits-all” policy, as individual circumstances must be taken into account when choosing an implant. Knowing the costs are also important, and the correct understanding of pro-surgery advertising as well.
– Can we believe in advertisements or we should doubt them? What about the forums?
– Online assessments have a huge influence on most patients. Of course, it can be helpful before the decision to gather first-hand information from others, but in the end everyone must have their own opinion, as sympathy and trust have a major role here. In other words: a personal consultation with the specialist of choice is essential.
Unfortunately, forums may deceit patients as well. There was a scandal a few years ago, because doctors made their assistants write positive feedback about them, pretending they are real patients. Many people find this absolutely reprehensible, just like the untrue public reports. Obviously, things can be easily unveiled, and the truth turns out sooner or later.
In many countries it is prohibited to advertise aesthetic plastic surgery on TV, radio and written press. I also think that many advertisements give a false picture about plastic surgery here, as the surgeries are shown from an unrealistic viewpoint, and many young – and unsuitable – patients go under the knife and suffer harm. In some places, non-medical but really persuasive staff gives advices on aesthetic procedures, often with discounts or tie-in sales, and the patients can meet the surgeon only after signing a letter of intent or a down payment. This is dangerous.
– Let’s talk a little more about implants. Nowadays there are various sizes, shapes and surface structures. How can patients navigate in this enormous diversity?
– It may be surprising, but they cannot. And they do not have to, as it is perfectly enough if we, plastic surgeons can. We have more than 1 000 variants in different sizes (including 700 anatomical and 300 round). Individual aspects are taken into consideration during the decision, which implant is suitable (e.g. height, weight, circumference of the chest, and asymmetry).
The requests of the patients are equally important. At the consultation, they can try on so-called “sizers” (test implants that can be placed into the bra) to decide what size they like the most. After many years of experience and performing several breast augmentations a week, I can say that I inform my patients accordingly.
– After a breast augmentation with implants, what does the follow-up care mean? What about the healing process? What should the patients pay attention to? When they can live a social life again?
– After breast augmentation, our patients spend one night at the clinic. On the day of dismissal, we remove the drains (if there are any) and put the special post-operative compression bra on them, which should be worn for 6 weeks.
During the first few weeks after surgery, the patients must not place their weight on their arm, and they have to avoid arm movements that are wider than 60 degrees, as the powerful movement of the arms and chest muscles increases the risk of possible complications.
The first follow-up examination comes after a week, and they are allowed to drive after 10 days. A second examination is due two weeks after surgery, when the stitches are removed.
Three weeks after the breast augmentation, patients begin to apply special cream and silicone patch to the surgical scar, then another week later they can sleep on their sides again if that is not painful. Depending on the situation, our patients may slowly start their sport activity on the fifth or sixth week: walking and jogging are OK. After the sixth week, the compression bra is not necessary.
– How do the patients communicate with you after the surgery?
– Of course we are available at any time after the surgery, even outside of consulting hours. During the dismissal from the clinic we give them our mobile phone number to call us in case of unexpected events or uncertainties. It is really important for me to provide security to our patients both before and after the surgery. They can call us with any questions or uncertainties at any time, or may come to us at the time agreed as soon as possible.
For optimal healing process, it is really important to have a cooperation between the patient and me. To achieve the best result, they have to follow medical instructions. I have no real control to make this happen, but I will see in the process of recovery. During the consultations, I emphasize that the patients should have realistic expectations – not just about the outcome of the surgery, but concerning the healing period as well. This guarantees the safety of the patient and these factors contribute to a well perceived and enhanced quality of life.
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