A “tailored” breast, like a bespoke dress

Breast augmentation surgery is a very delicate and often the expectations of patients are in conflict with maintaining the harmony of body proportions. For this reason it is important that the plastic surgeon performs a thorough analysis of body structure before deciding on the type of surgery and implants to be used.

In order to obtain harmonious, safe and long-lasting results Dr. Cicogna uses (In the pre surgery phase) the TEPID Technique (High Five System). Created by Texan surgeon John Tebbetts, tepid analysis allows us to measure precisely what is the best size to be fitted in body of the patient. The measurement takes place via a mathematical algorithm that is obtained from the analysis of different factors such as height, weight, chest (circumference and distance between the armpits), distance of the nipple from the jugular or clavicle, as well as the thickness of the breast tissue to verify the capability to hide the prosthesis once implanted.

In this interview Dr. Cicogna details what is TEPID and why it is critical to every case.

It is a detection system body characteristics that uses a scientific method based on empirical parameters. To date the system has been implemented and simplified: provides only five measurements on the needs of the pre-operative assessment (High Five System, also known as the “system of the five T”). The process of selection involves the patients’ involvement and careful consideration of their expectations and requirements.

The analysis of the body and tissues is of critical importance to assess the outcome of the intervention, both in the short and in the long term. A wrong prosthesis increases the risk of complications for the patient in the postoperative phase.
Instead of forcing the tissues of the patient to get to meet his demands, it is appropriate to insert breast implants that adapt to the tissue characteristics, thus giving priority to harmonious and long lasting results.

The technique of analysis primarily evaluates the ability of the breast soft tissue to cover effectively the implant for the patient life; the level of weight and pressure the tissues will be able withstand and the best position of the breast in the chest.
Everything is detected in five measurements:

  • Linear measurement of the width of the base of the breast;
  • Measuring the thickness of the soft tissues through manual tension;
  • Measuring the distance to the nipple-line and the amount of breast tissue present;
  • Choosing the type and size of prosthesis based on previous measurements;
  • Definition of the positioning of the prosthesis, the measures of the post-intervention intermammary sulcus and the incision place.

The parameters evaluated with TEPID allow defining the key elements of the intervention.

First of all, the size of the prosthesis to be implanted (shape, volume, weight). It will depend on the amount of soft tissue present in the breast and its ability to cover evenly and naturally the prosthesis. Through this analysis is possible to avoid discomfort such as wrinkles, thinning, scarring, atrophy and bumps.

Secondly, one can predetermine the optimal positioning of the prosthesis with respect to the thoracic cavity, through the evaluation of the nipple-intermammary sulcus and distance between the nipple and the sulcus.

Finally, it is possible to decide where it is optimal to make the incision, in order to prevent trauma, infections or damage to the neurovascular system.

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