The Use of An Anthropometric - Based Pre-Operative System to Choose Implants in Primary Breast Augmentation - An Outcome Analysis

Purpose: Preoperative systems that mathematically select “the one best implant” have been developed. However, they fail to take into account the patient's desires regarding aesthetic outcome. This prospective study evaluates an anthropometrically-based system, which enables both the surgeon and patient to choose an appropriate implant. Methods: Nine plastic surgeons enrolled every patient operated on for primary breast augmentation from September 2008 - 2010. They based all their implant choices on the described system. Postoperative outcomes in terms of satisfaction and reoperation rates were studied. Results: One hundred and forty two primary breast augmentation patients were enrolled and followed during the 2-year enrollment period. The mean overall and breast size satisfaction rates at the 3-month and 12-month time periods reported by patients were 94.7% and 93.64%, respectively; and by surgeons were 94.86% and 94.84%, respectively. There were no reoperations reported for size change at 5 years. We found that 44 (31%) patients had ≥ 3 high risk factors (HRF) for poor outcome. Eleven (25%) of them had a ≤ 80% satisfaction rate, compared to 8 (8.2%) of the patients who had <3 HRF (p=0.014). Despite this, the vast majority of this difficult patient population (n=33, 75%) had a >80% satisfaction rate with the use of this system. Conclusions: The anthropometrically-based system guided surgeons and patients effectively in choosing implants that resulted in high outcome satisfaction rates and no reoperations for size change. This system was especially successful in difficult cases that have a high risk for poor outcome.