The Surgeon Minute

Customizing Breast Implants

Customizing Breast Implants

Recently, silicone gel implants celebrated their golden anniversary: 50 years of progress albeit peppered with a few years of controversy. The science and research ultimately exonerated any lingering fears about safety and effectiveness, so women can confidently choose silicone implants…but which one? Dr. Robert Grant of New York City says that over the past 5 years, there have been more innovations to the shapes, types and styles of silicone implants than in the prior 45 years altogether.

by Terrye Tebbetts
and Robert Grant, MD

The designs of the new implants give both breast augmentation and breast reconstruction patients options that did not exist even a few years ago. Dr. Grant explains. “Now we can talk about the different styles and types individualizing the kind of implant the patient desires and (the look) I think I can achieve for them.”

Form stable implants, also known as “gummy bear implants” were made available in the United States in early 2013. These implants are built to retain their form and shape. Grant is a proponent of the “gummy bear” cohesive gel implant, particularly for his mastectomy patients. “In my practice, I find these exceedingly helpful for my breast reconstruction patients. They help the skin left after a mastectomy really conform to the breast’s shape and give a better result than a round implant can give.”

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Smooth vs. Textured Implants

First generation smooth round implants have just now undergone an enhancement of their own. Grant refers to it as “the hot, latest exciting news.” Two manufacturers have introduced a higher percent fill in the silicone envelope of round implants. Translation: More upper pole fullness with less rippling regardless of the body’s position. “When using this implant for breast augmentation, the fill in the upper part of the breast is significantly better than the former generation,” says Grant.

In the past, to get the same degree of fullness, a larger implant would have to be considered in which the tradeoff would be a less natural look, especially for thin patients. “This (new implant) gives patients what they want in terms of an enhanced appearance but not one so stigmatizing that the breasts look like beach balls or so artificial that they are a dead giveaway.”

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Grant is also using these newer implants in his mastectomy patients who are candidates for the skin and nipple sparing procedure–a technique that removes all the breast but preserves the entire skin envelope along with the nipple and areola complex. “This means more of our reconstruction patients are really being looked at with the same surgical approach as breast augmentation patients…and enjoy the same advantages.”

Overall, Grant is tremendously excited about the choice of profiles, widths, sizes and shapes both in the round, smooth implants and the form stable implants. “The versatility is so much better. I’m able to really individualize results.” Despite his own enthusiasm, Grant knows a delighted patient is at the heart of his satisfaction, and the good news is patients are just as thrilled. “Patients need to be happy with their results…they are looking at themselves every day.”

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