Denise Richards opens up to Us Weekly about her breast implant misadventures. Typical to Hollywood starlets, she blames the problems on her surgeons:

“When I was 19, a doctor put in bigger implants than what I asked for. I was in such a hurry to get them that I didn’t research my doctor,” Richards says. “I just thought because they’re a plastic surgeon, they must be good. You have to be your advocate for your own body and ask 100 questions.”

While I agree about the asking questions part, patients need to do more than that. They need to communicate their desires and risk tolerance to their surgeons. The philosophy of the surgeon can be just as important as his or her qualifications here. Some surgeons tend to place larger implants than others. Patients do better over the long term with intermediate-sized implants as we have said here before many times.

The priority can be how to make the implant procedure a more long lasting endeavor.

Typically patients come in asking for a particular size and not direction on choices for longevity. Of course what Denise and her surgeon discussed in the eighties is not to be known. I have plenty of patients who are wearing the same implants I put in over a decade ago, so longevity with moderate implant sizing and quality surgery works.

Her Us Weekly story goes on:

When she met with another surgeon to have them corrected, the doctor gave her even larger implants. “I felt very vulnerable,” she tells Us. “I was getting ready to film [1998's] Wild Things, and I didn’t want to get into a lawsuit with some plastic surgeon. It wasn’t right what the doctor did, but it is what it is.”
Source: usmagazine.com/healthylifestyle/news/denise-richards-
why-i-regret-my-boob-jobs-2011287

Again I’d wager Denise did not communicate much with her surgeon. Probably the most important issue is whether or not the targeting was for “long term” or “larger size.” As we have said, these goals are often mutually exclusive.

Frequently patients with “droop” will not accept lifting procedures and opt for larger implants to avoid the “need” for a lift. This is a short term solution at best and usually ends with lifting and implant downsizing often years later.

Denise’s story may be even more complicated. She was married to Charlie Sheen remember?

Best Regards,

John Di Saia MD