Book NowBREAST AUGMENTATION OR AUGMENTATION REVISION WITH LARGER SIZE IMPLANTS THAN RECOMMENDED BY DR. LAVERSON
I have discussed with Dr. Laverson and fully understand and accept the following with regard to my desire for breast augmentation using an implant larger than Dr. Laverson feels is optimal for my breast tissue and my body proportions.
My signature on this page confirms that I fully understand each possibility listed below.
All of my questions have been answered, I feel informed, and I accept each risk and each potential problem listed here, as side effects of having the large breast implants that I prefer:
As I get older, my breast skin will age, stretch and become thinner even without an implant. The larger any breast, augmented or not, the worse it will look over time due to skin stretching.
Adding any implant to my breast adds weight and will produce stretch and irreversible thinning of my breast tissues over time.
The larger the implant, the greater the amount of breast tissue stretch that will occur.
Adding excess weight to the breast almost guarantees that it will look worse over time, with increased stretch and sagging. It is impossible to predict whether or when this will occur in any individual patient.
Adding weight to my breast with a large implant may cause me to need further surgery in the future, particularly mastopexy (breast lift) with additional visible scars. I will incur additional costs, time off work, risks, and tradeoffs if additional surgery is necessary.
Excessive breast tissue stretch from a large implant can make me more likely to have surgical complications with healing problems if the tissues become very thin.
As breast tissues thin, I will definitely be able to feel my implant. Portions of the implant may be visible through my skin and visible rippling or wrinkling may occur.
If excessive stretch or complications occur (and this is unpredictable), it may become necessary to remove the implants or to have breast lift surgery with compromise in the appearance of my breasts and perhaps visible scarring.
I accept full responsibility for every possible outcome of my decision, whether that outcome or risk is known or unknown to me and to Dr. Laverson.
I prefer large breast implants, and understand and accept all of these risks, limitations, and tradeoffs. I request that Dr. Laverson proceed with larger than optimal implant augmentation of my breasts. I have had an opportunity to have all of my questions answered to my satisfaction, and am totally comfortable with my decision.
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Patient: (Please print) Witness: (Please print)
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Patient: (Please sign) Witness: (Please sign)
