These Plastic Surgeons Say Determining Size Is the Hardest Part of the Breast Augmentation Process—But These ‘Predictors’ Help

When New York plastic surgeon Jeffrey S. Yager, MD opened his practice in 1997, he took out a loan to buy the Mirror Image system so he “could do all digital storage and use the latest technology for simulating the results of cosmetic plastic surgery,” he recalls. “It cost $50,000 then and was well worth it.”

Mirror Image has since been acquired by Canfield Systems—and is now known as Vectra—but is still widely used in the aesthetics field, including in Dr. Yager’s office some 24 years later.

“I find it very helpful for simulating two-dimensional results like nose reshaping in profile or liposuction, but I do not use it as often for breast augmentation,” he says. “The module has improved, but in my practice, I find by accurately measuring the patient and looking at before-and-after images, I can more clearly determine the best implant size and profile to achieve the desired look. The software does not yet reproduce the natural give of skin and breast tissue in real life.”

Likewise, Reno, NV plastic surgeon Tiffany D. McCormack, MD, who relies heavily on sharing before-and-after images for patients, uses the Vectra technology in her office as well—and that includes for breast procedures. “It really helps me during my breast consultations. We can review different sizes together, which patients find so helpful. Determining size can be the most difficult part for them. It also helps us decide whether or not a breast lift would be beneficial in certain cases.”

Pasadena, CA plastic surgeon Lily Lee, MD chooses to use silicone gel sizers for her breast augmentation patients, which they try on in the office. “It gives the patient the ability to hold the implant so they know exactly what they will be getting. I always encourage them to come to the pre-op appointment with a number of items of clothing that they usually wear. This way, they can see what it looks like in different clothes. Some of my clients will bring their entire closets to try on implants with!”

The bottom line, La Jolla, CA plastic surgeon Robert Singer, MD says is that all of the above serve as “good communication tools” to make sure the patient and their surgeon are on the same page—and that is a vital part of any good result.

“There are a variety of ways you can make sure you’re on the same page: Technology, 3D imaging, having the patient look at or bring in photos of what they would approximately like to achieve—but having the understanding that they might not get that exact result or shape,” he adds. “Trying on sizers in the office with a bra or T-Shirt also gives you an idea of what direction you’re going in. One option isn’t better than the other; there’s not one way to do it.”

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