Breast Augmentation: General Principles and Outcomes

https://plasticsinpractice.com/ Breast augmentation is one of the most performed aesthetic operations—and still one of the most revised. This episode is a practical, surgeon-to-surgeon breakdown of how to drive reoperations down by treating planning as the operation. We walk through a tissue-based philosophy: objective measurements (not cup-size promises), pocket selection that matches coverage needs, and operative decisions that prevent predictable failures like malposition, rippling, and capsular contracture. Key takeaways (resident-focused): Reoperation rate is the scoreboard—plan backwards from the revision causes. Use objective sizing frameworks (e.g., High Five™ / TEPID) to reduce size-exchange revisions. Dual-plane logic: coverage where you need it, expansion where you want it—without iatrogenic damage. Rippling prevention is coverage math (pinch thickness rules matter). Capsular contracture: think contamination + biofilm risk; incision choice and technique aren’t “small details.” BIA-ALCL: know the textured implant association and the classic delayed seroma presentation. Disclaimer: This content is for educational purposes only and is not medical advice. Hashtags: #PlasticSurgery #BreastAugmentation #AestheticSurgery #PlasticsResidency #CapsularContracture #DualPlane #BIAALCL Citations (AMA; numbered; alphabetical bibliography): Tebbetts JB, Adams WP Jr. Five critical decisions in breast augmentation using five measurements in 5 minutes: the High Five decision support process. Plast Reconstr Surg. 2005;116(7):2005-2016. PMID: 16327616. Tebbetts JB. A system for breast implant selection based on patient tissue characteristics and implant-soft tissue dynamics. Plast Reconstr Surg. 2002. PMID: 11964998. Pajkos A, et al. Detection of subclinical infection in significant breast implant capsules. Plast Reconstr Surg. 2003. PMID: 12655204. Li S, et al. Capsular contracture rate after breast augmentation with periareolar versus other incisions: a meta-analysis. Aesthetic Plast Surg. 2018. PMID: 28916908. Sharma B, et al. Breast implant–associated anaplastic large cell lymphoma. Lancet Oncol. 2020. PMID: 32302264. 6. U.S. Food & Drug Administration. FDA requests Allergan recall of BIOCELL textured breast implants (2019). 🎧 Full episodes available now: Instagram: https://www.instagram.com/plasticsinpractice/ Spotify: https://open.spotify.com/show/4Ct8jOgYXP9QJin7QOuG3Z?si=JNcBxQmwT2mfz1LSJZEFKA Apple: https://podcasts.apple.com/us/podcast/plastics-in-practice-resident-review/id1835564216 YouTube: https://youtube.com/@plasticsinpractice?si=tqLInp5vvsJFKlRO Amazon: https://music.amazon.com/podcasts/8bef056e-7c87-4224-978e-7e691b04554a/