Your plastic surgeon might say NO—here’s why! [Dan Zegzula, MD, Portland]

Eva Sheie (00:00):
You're listening to Where Before Meets After. So are you asking them a lot of questions when you meet them at consultation to figure out what direction you're going to go?

Dr. Zegzula (00:08):
Yes, absolutely. I think patient's goals are where we start. What are you trying to achieve from this operation? What are your goals and how can I help you get there? I think those are important things to ask and important answers to get before making a plan. Many times after nursing, there's going to be some ptosis involved, so lifting and breast reduction, that's also kind of a spectrum. If you're lifting a breast but not making the volume smaller, then we're talking about a breast lift. But if we're lifting the breasts and bringing the volume down, a couple of cup sizes, then that's a breast reduction. Many times patients are surprised when I tell them, I think maybe insurance will pay for your breast reduction. And a mommy makeover that's partly done under insurance is always a special treat for them. They weren't expecting that insurance would pay for any of it, but if they meet certain criteria, then the breast reduction part of it might be covered under insurance.

Eva Sheie (01:05):
Do you ever find yourself disagreeing with someone's goals?

Dr. Zegzula (01:10):
Perhaps the most common disagreement would be patients who are asking for breast implants that are larger than their frame would support. So I have to educate them about the risks of that and how their bodies, their tissues might not support a large implant over long periods of time. There is a range in which I'm comfortable with. I try and talk them through the process and my thinking about the operation and what I think is safe. On rare occasion, I would just have to tell them, I can't be your surgeon if this is what your goal is. I can't achieve that safely, but that's a rare thing

Eva Sheie (01:46):
Around Portland and in the Pacific Northwest, do you feel like there's a specific style or a trend or a way that the women in that part of the world want to look?

Dr. Zegzula (01:56):
Yeah, I think geographically there are differences in what patient's goals are. I think one easy one is the average breast implants that are being put in are larger, the farther south you go. So in Southern California through Arizona, Texas, and all the way to Florida, they're putting in on average, larger implants. In the more northern states, smaller implants, more of a sporty and athletic look than a busty curvy look. Certain geographic areas, you're going to have people that want everything, but I think on average, we're more conservative in the northern parts of the United States with implant size and bust size.

Eva Sheie (02:38):
Thanks for listening. I'm your host, Eva Sheie. Follow the show and submit questions for our experts at wherebeforemeetsafter.com. Where Before Meets After is a production of The Axis.