Breast Surgery Consultation: What To Expect

Speaker 1 (00:03):
Welcome to Kind of Beautiful with board certified plastic surgeon Dr. Tracy Pfeifer, the podcast for women seeking the very best of modern beauty.

Dr. Pfeifer (00:17):
During breast surgery consultation, whether it's in the office or via a Zoom call, I meet with the patient, talk about her current situation, what she would like to improve or change, and then we discuss the options. So for example, it could be a breast reduction, a breast lift, a breast augmentation, maybe she needs revision of prior implant surgery. We go through all of her history, you know, what, what happened before, what symptoms is she having now? How have her breasts changed? How would she like them to be? And then we can discuss different options with the pros and cons. If it's a breast reduction surgery, it's usually pretty straightforward in terms of describing, you know, her goals in terms of cup size. But we always have to remind people that cup size is variable depending on the bra manufacturer. But the basic idea is to get a baseline of what her size is now and then communicate to the patient what size could she achieve.

(01:20)
So sometimes if the person is in the uh, office, you know, physically in the office, I'll be able to stand with them in front of a full length mirror and kind of show them what size I'm talking about so that she can get an idea because that's always a, a question. Well if I think I'm a double D and I'm saying I wanna be a small C, like is everybody on the same page visually? So visualizing things as much as possible really helps. That goes with any breast surgery at all. Another thing I'll usually have the patient do is show me some pictures of sizes that she thinks is appropriate for her that she finds tasteful. That would be in proportion with her figure. And that's also very helpful to have that besides verbal communication, to have that visual communication about what her aesthetic sense is, whether we're going smaller or bigger or revising anything that's very, very important.

(02:12)
And then we talk about the possible downsides. You know, what are some of the little things that can happen? There's usually no major complication with any of these surgeries, but there are small things that can come up, like maybe we have a scar that's not as fine and delicate as we want it to be and it might need a scar revision, things like that. And we talk about anesthesia also so that the, a lot of times patients will be worried about anesthesia. They might not have ever had surgery before, so they're not sure what to expect. So I find it's very helpful to really go through that in a lot of detail. If the patient wants it, you know, this is exactly what's gonna happen. Um, they'll also have questions about what they're gonna do for pre-op to get ready. We always do a medical clearance on all our patients so that even if there's some little minor thing, we get it straightened out ahead of time.

(02:58)
We don't have to worry about it and everybody's totally healthy going into surgery, when we talk about the post-op course, you know what bra they're gonna wear, what the medication schedule is gonna be, <laugh>. I actually usually go into some of this at the initial consultation because patients wanna be comfortable after surgery. So a lot of them are worried that they're not gonna be comfortable. We want everybody on a scale of one to 10, where one is nothing, 10 is significant discomfort, want everybody to be like a two or a three. So it's very helpful to give them this information. Some patients right away don't want as much information as this, but I find that most people do because they have these questions, it's natural. And then at the very end of the consultation, after I've answered all their questions, they'll meet with one of the patient coordinators and they will receive a written quote which will go over all of the financial information about the cost, et cetera.

(03:52)
If it happens to be covered by insurance. Then we also talk about that whole process. And we can talk about that in more detail later if, if you want to, because some procedures are covered by insurance. And then usually patients are interested in looking at the calendar cause they wanna see what days are available for them to have their surgery. So when you first come to the office, you're gonna be obviously dressed in your street clothes. I like to meet the patient before they've changed so that we can have a discussion human to human <laugh>. And then I'll step out of the room, the patient will change just for the breast area, obviously we just need to take the top and the bra off. You get a surgical gown and then I'll examine you, take some measurements. And a lot of times if it's a breast reduction, like I said, we'll step in front of the mirror and we'll kind of visualize what volume we're talking about.

(04:41)
If it's an augmentation patient, we use a little surgical try on bra. We try on implant sizers in a bra again standing in front of the full length mirror so that we can see what our proportion is and what looks good with our figure. So yes, you have to get undressed from the waist up. So when you come in for especially a breast augmentation consultation, it's always a good idea to bring uh, different tops. And we remind patients to do that ahead of time. So your normal clothes a t-shirt, lighter colors are better. T-shirts, sweaters, shirts, your normal clothes that you feel comfortable in so that when we put the sizers on in the surgical try on bra, we can then put your clothes on top and you can look in the mirror full length and say, yeah, I'm comfortable with this. My clothes still fit. Now some people want their clothes to be a little snug, so they actually would need to size up, but some people basically just wanna fill out their bra a little bit better.

(05:35)
So it's important to them, especially if they've invested in a wardrobe that their existing clothes are gonna fit after surgery. So that's really helpful to bring different tops to try on dresses. It could be any bathing suit, it could be really anything. And that is also reassuring to the patient. It's all about how do you see yourself, you know, what are you gonna look like after surgery? And that's really hard to communicate. Some offices use, um, an imaging system to try to visualize the postoperative result. I used to do that, but I found it was actually kind of confusing the patients because the imaging wasn't as accurate as what it's actually gonna be in real life. So we stopped using that. But imaging is another way to visually communicate. Other things that patients should bring to the consultation are images of before and afters that they love, or it could just be breasts that they love, both with clothes on and out of clothes because you can have a result that looks acceptable in clothing, but when you actually look at the person without any clothes on, the proportions are often it's not right.

(06:40)
So I really like to see pictures without any clothes on <laugh>, uh, to see the before and afters or just the breast alone that you like. And I always tell the patients, bring something that you love. Bring some pictures that you like but not as much. And then even some that you don't like, because this is all about taste and what appeals to you. There's no right or wrong. I'm just trying to understand your particular aesthetic sense. So if it's like, if you say, well, I like a blue red lipstick, well there's a million blue red lipsticks. So if you're brought in an actual shade of blue red that you like, you say, I love this one, I like this one, but not as much. Then I, I get it. I understand what's going on. So it's the same thing with pictures. I need to see pictures that you, that you like and some that you really don't like.

(07:30)
And then I can say, oh yes, this is what's gonna look good. Not only for your dimensions, which we'll talk more about that in a minute, but it'll look good on your figure. But I can also say, okay, this is the implant that we're gonna be thinking about using because it's gonna deliver the result that you want. There's a lot of different implants to choose from. We don't wanna give everyone just the same implant because we've used that one. You know, our whole career there's hundreds to choose from and we wanna pick the one that works best for you and it's gonna deliver the aesthetic result that you particularly want. When we do virtual consultations for breast surgery, it's pretty straightforward for reductions. It's a little harder to communicate sizes, but we can look at pictures on the internet and find a size that the patient feels comfortable with so I can have a good idea about what she feels is good for her.

(08:16)
With breast augmentation, it's a little tougher because I really do need to take some measurements of the breast width and the breast height and get a feel for how thin or thick the breast tissue itself is. But we can still do a lot of preliminary planning based on pictures that the patient sends to me ahead of the Zoom consult for what she likes and doesn't like. Uh, usually what'll happen is the patient will send me some pictures of herself from the shoulders down to just above the belly button. She'll send those to us. So I have them ahead of time so the patient's not getting undressed on the Zoom consult, but I'll have those of her own pictures and I'll have some pictures of breasts that she thinks are pretty. And then based on that, we can have a very accurate discussion about what type of implant would probably suit her best.

(09:07)
And of course, we have to finalize that when I see her in person, which we always have to see the patient in person before surgery. We take the patient's preoperative pictures either at the time of the initial consultation or at the preoperative visit, which is usually three to four weeks before the surgery. When patients are ready to schedule a, typically we're looking at a, usually a six to eight week time period before there'll be a surgical slot available. There are slower times during the year. For example, mid-August can be easier to get time. Certainly the spring is harder. I think now we're probably booking into July or maybe even later than that. So depends on the time of year. It also depends on the length of the procedure. So if we're looking for a two hour time slot, it's gonna be easier to find that than a four hour time slot in the schedule. If you're ready to schedule a consultation, uh, either in person or via Zoom, just reach out to us either directly through our telephone numbers, which are listed on the website, d r pfeifer.com. So it's dr pfeifer.com. Also on the website, you can find a contact page, just, uh, send us, uh, fill out the contact form and it'll be forwarded automatically to Arlene and she will reach out to you within 24 hours. And we would look forward to hearing from you.

Speaker 1 (10:29):
To learn more, go to kind of beautiful podcast.com or follow Dr. Pfeifer on Instagram at Dr. Tracy Pfeifer, spelled P F E I F E R. Links to learn more about Dr. Pfeifer and anything else mentioned on today's show are available in the show notes. The Kind of Beautiful Podcast is a production of The Axis, t h e a x i s. io.