Kristi Reasons-Look, licensed esthetician; Dr. Marissa Tenenbaum; Emily Weinhaus, PA-C; Dr. Terry Myckatyn; and Kristin Green, licensed esthetician

Communication is the key to any relationship—and your relationship with your doctor is no different. At West County Plastic Surgeons of Washington University, the high level of communication is the most-often cited reason that patients are happy with the outcome of their cosmetic procedures, says Dr. Terry Myckatyn. “The reality is, it’s not necessarily the type of breast implant they choose. We get a lot of positive feedback for the communication beforehand. They understand what they’re getting themselves into and have a better sense of what to expect,” he notes. “That matters. If someone is seeking implants and it turns out that’s not really what they want, it’s better to figure that out before the operation.”

To aid communication, patients typically have two consultations before their surgery, Myckatyn says. In addition to having a frank discussion about expectations, the physicians are able to give a clear picture of what the results will actually look like using new 3-D imaging software called Vectra XT, notes Dr. Marissa Tenenbaum. “It’s a great tool for the surgeon because it gives you a more realistic way to have a conversation with the patient: You’re looking at the same thing while you’re having the conversation,” she says. “Some people are going to be much better at a visual representation, rather than trying to describe what they want with words.”

Having this visual representation is even more valuable with the adoption of new breast implant options, several of which were approved by the FDA a little more than a year ago, the doctors say. These implants, known informally as ‘gummy bear’ implants because of the more solid consistency of their interior, include Allergan’s 410 and Sientra’s Silimed, Myckatyn notes. The firmer gel addresses a big criticism of ‘traditional’ silicone implants, which is rippling, he says. The newer implants also tend to cause less scar tissue, and early trials suggest that they will last longer than the 10- to 15-year lifespan of traditional implants, he adds. As patients become more comfortable with these newer implants, their use is increasing, Tenenbaum notes. “In my practice, it’s already well over half,” she says.

The practice also sees many patients who are having reconstructive breast surgery, often on the same day as surgery to have a tumor removed. “Reconstruction is a multi-step process,” Myckatyn notes. “It’s a more complex discussion because it depends on what sort of cancer they have and what other treatments they need. We’re treating a much broader population of people—some have very large breasts or they’re older and wouldn’t have thought of going to a plastic surgeon in the first place. They’re often less healthy to start off with, as well, and these are all things we have to take into consideration.”

So regardless of the cause of any patient’s visit, creating a clear and accurate expectation of the results is the doctors’ primary focus. “It’s important that I know what they’re looking for, where they’re starting from, and where they want to be,” Tenenbaum says. “Then I can provide education for them about what we can expect, in terms of recovery, the risks of surgery, and whether this is a good option for them. My main goal is that I want them to feel really empowered to be making these decisions, and confident that they are in good hands.”

On the Cover: West County Plastic Surgeons of Washington University, a full-service cosmetic and reconstructive surgery practice, is offering a new generation of breast implants, including Allergan’s 410 and Sientra’s Silimed, as well as 3-D imaging software, Vectra XT, to help patients visualize their results. Pictured on the cover: Drs. Marissa Tenenbaum and Terry Myckatyn. For more information, call 996-8800 or visit

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