One of the most common reasons for re-operation after breast augmentation is for purposes of size change–usually to become larger. At the Baystate Center for Plastic Surgery, Dr. Delia takes every effort to avoid this additional surgical procedure by actively involving patients in the decision-making process. During the initial consultation, patients goals are discussed, measurements are taken, and patients examined. A fitting bra may then be used with a variety of breast implant sizers until the desired shape and size is achieved. A second visit is then scheduled giving the patient time to think about her choice and the sizing process is again repeated. A discussion ensues regarding anatomical concerns Dr. Delia then discusses anatomical concerns which are unique to each patient and advises regarding concerns about type of implant implant(silicone vs. saline), the choice of shape for the implant(round vs. teardrop), and other technical problems are all addressed. After the second consultation for breast enhancement surgery, most patients feel comfortable with their choices and have narrowed down the size of the implant they prefer (to within 25 cc or so which typically represents only a small fraction of a cup size). However, if there is still a concern, some patients will be asked to schedule another visit to finalize the most appropriate options for their breast enlargement surgery.

At Bay State Center for Plastic Surgery, we never pressure patients into making quick decisions. We want happy, satisfied patients. We engage them in the process and have them actively participate in breast implant selection. We also make sure the patient understands any concerns the surgeon may have regarding their choice. With this approach, we find patient satisfaction to be very high and re-operations for breast augmentation surgery are kept to a minimum

Hyaluronic acid fillers, such as Juvaderm(Allergan) and Restylane(Medicis) have been used for some time for facial rejuvenation. These products have been subjectively thought to provide excellent results with good safety, longevity by many plastic surgeons and dermatologists. Objectively, however, longevity of these products have not been well documented.
A recent study in a major peer-reviewed journal of plastic surgery has demonstrated excellent persistence of these fillers in the tear trough area ( the depression between the lower eyelid and cheek) through use of 3-dimensional imaging.
This is an area where patients may look tired and aged with bagginess of the lower eyelids and loss of soft tissue volume of the cheeks over the years. Although, there may be other surgical options such as an eyelid lift (blepharoplasty), for those more interested in nonsurgical treatments , hyaluronic acid fillers continue to represent an excellent option with good longevity, particularly in the tear trough area.
Stephen Delia, m.d.