Journal time!
I just got the October 2018 issue of Plastic and Reconstructive Surgery Journal, and they had a supplement on breast implants. I consider myself kind of an expert at this point after over 20 years of working with implants, and I use all kinds of implants- silicone, saline, shaped, round, all of the different profiles. So I admit, I skimmed this article as I thought there was nothing to interest me. I was wrong.
I was drawn to the section of “A combined Approach: Overall Device Performance.” I do not think of breast implants as being like a car. Performance of a silicone breast implant? What does that even mean? So I read on. The authors of the article are icons of the breast surgery field in plastic surgery. I thought their points deserved mentioning.
- There are many parameters of the implant which can be changed:
- gel cohesivity
- shell thickness
- shell surface
- implant gel fill
- These can affect feel of implant inside and outside of the body
- There are differences between companies.
- Mentor Memory Gel Xtra- optimizes to get an implant with a firm apex with an overall soft feel. (**OF NOTE: for my Bay Area patients, you may not like this. “firm apex” means cleavage look. If you are going for a more subtle, natural look, you may not like this)
What do I think?
The author is an advisor for Mentor, so there is likely some bias. But I do think the companies have different shell thickness and different gels in their fill. There are increasingly more options to think about. How firm do you want the implant? How much do you want it to be form stable (which means it keeps full in the cleavage area- it doesn’t settle as much as the softer gels)? If you are doing a textured implant, the companies all have different types of texturing. Does this affect feel? capsular contracture rates? There are some indications that the ALCL rates vary by company. See blog on ALCL rates by company HERE.
All these choices give patients more options and help us craft the best implant for you and your desires. That is a good thing.