I have been Dr. Tebbetts' patient educator for 21 years and just when I think I have seen and heard it all.....every once in a while, patients are still able to surprise and amaze me.

A patient who has had her saline implants now for 6 years called me raving about how Dr. Tebbetts is one of the best breast augmentation surgeons and how fantastic her result is and has been for all these years.  I love hearing how happy patients are and how well their new breasts have enriched their lives over time.  But, I hate hearing the word BUT!  As she finished her glowing report, she then said the dreaded word....BUT....I want to change them out to silicone and go bigger.

My first responsiblity is to find out if there are any clinical, medical reasons to go back to the operating room.  So I asked, "Are you having any trouble?  Any change in shape?  Any hardness?"  "Nope - Dr. T did a fantastic  job, I just want them switched to silicone and want them to be bigger."  I asked her to send photos so that I could see what she was seeing and see if there might possibly be a way to honor her request - if there might be any reason to justify the risks of returning to the operating room.

To my delight - they are beautiful, natural breasts.  To my dismay, she is no longer satisfied.

So I have to ask you.....if you did not know this was a breast implant, would you know this was an implanted breast?  If you had this result, would you want to change it?

I don't know.  Maybe it is because I am acutely aware of all of the risks and tradeoffs of going back into the operating room - but I don't want to go there unless I absolutely have to.

Going back into a good, long-term cosmetic result without a medical reason, subjects the patient to all of the original risks - infection, hematoma, capsular contracture, general anesthetic risks....all risks that were associated (and averted) with the surgery the first time.

So it begs the question...once we have more than we started with, why can't we be happy with having more?  When it comes to breast implants, why do we have so much Boob Envy that we are willing to put ourselves at risk?

Bigger is not better - in fact, often it is worse and ugly.  I would love to know what you think  because this one leaves me scratching my head.