All plastic surgery should begin with a mutual understanding of patient expectations. Surgical treatment can only be as successful as the goals set at the onset. How tuberous breast surgery works can be quite complex, having clear goals is an important indicator for a realistic and successful outcome. However, expectations should be tempered by an understanding of the variability in tissue healing. Tissue tightness and swelling are necessary in all breast surgery, but particularly so in tuberous breast reconstruction. The breast implants widely used can take their own time to settle. Some implants sit perfectly the very next day after surgery, and some need a gentle massage by the surgeon to shift them to the right position in the early weeks after surgery. Occasionally, a bigger push needs to be made into the pocket at a later stage.
Breast implant position is not just dependent upon the skill of the surgeon; variables include the tissue and anatomical differences in each patient. Anatomical variables not only predict the final result but can also reduce the risk of complications if adequately addressed during surgery. Inadvertent tissue damage during dissection can thwart the best plan. More complications can occur when a patient has co-conditions such as smoking and obesity. Perhaps most important is the variation of human beings from the emotional, psychological, and philosophical perspectives. Not all humans have an identical conception of what looks good and beautiful. Some like upper fullness, some prefer bottom fullness, and some prefer middle fullness. What invokes symmetry and balance in one person might repulse another. What looks good to some can be revolting to others. Consequently, experience shows that individual responses to how tuberous breast surgery works may be unique. Despite the wide gamut of variables that contribute to the outcome, a significant percentage of patients undergoing tuberous breast correction rated their outcome as good or very good. The difference in size observed before surgery is often still visually appreciated after surgery is performed to correct two opposing conditions. Surgeons expect to correct these conditions to come together, but on occasion, they take a little while to complete the journey from their opposing positions. Adherence to the constructed plan can minimize frustration if it were to occur, but a realistic understanding is that the best plan is refined on the day in the operating room when the body’s exact anatomy may finally be exposed for the first time. A little patience regarding a larger implant settling and another undergoing a small elevation can make a crucial difference to the patient’s experiences on both sides of the operating table. Ongoing input from each other can provide the best results.
