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In our practice, we decided many years ago that it was not productive to try to plan a patient’s operation based on something that either did not exist or something that had nothing to do with the patient’s body! Think about it – most women talk about their breasts in terms of cup size, right? But there is no standard definition for cup size in fashion – they are different depending on the designer or the store or whether it is strapless or underwire, whether it came from Target or Victoria’s Secret. Not to mention that there is NO, not one, clinical, scientific definition for cup size! So how can surgeons and patients communicate effectively and plan an operation based on something that has no true standard measurment? On the same note, how can you take a photo of another woman into a surgeon and say, “Here, this is what I like. This is what I want my breasts to look like?” Have you ever tried that with your hair dresser? How’d that turn out? It just floors me that surgeons and patients are changing bodies with out taking the body that they are changing into account!
Thus the evolution of measurements. Dr. Tebbetts started developing a system of measurements that would quantify the void in a breast, telling us what that breast envelope will hold safely within the limits of the patients tissue. The definitive system is called the High Five System. It is very simple, but extremely accurate. By being objective and putting numbers on the operative plan, the surgeon and the patient are working together with each other to augment the breast while respecting the tissue. In doing so, you limit weight and by limiting weight, hopefully allow the result to last longer and look beautiful as it ages gracefully with the patient.
The High Five System is something patient can even do at home on their own to get an idea of what implant size they will need. The system is detailed in The Best Breast 2 and I have worksheet that I often email to patients so that they can try it for themselves.
It just makes sense – having breast implants is still having surgery. So if it is surgery, the planning should be clinical and objective. If you walk into the ER with a ton of terrible symptoms, they don’t hold up photos of other people who kind of had the same symptoms to figure out what you need, do they? Last time I checked, they run tests and do things like MEASURE your temperature and your blood pressure – - science – objectivity. If we can all get comfortable applying a peer reviewed and published measurement system, High Five, to breast implants – perhaps we can eliminate shades of grey and expectations like -”I’d like to be a Full C/Small D, doctor.”
The High Five System was published in Plastic and Reconstructive Surgery Journal and is visible on The Best Breast 2 website under News and then Scientifc Articles.
