The breast implants of 2021 are more natural looking than ever before. Women who go to Dr. Sattler at Sound Plastic Surgery in Seattle are confident that they are going to get breast implants that look and feel natural for their individual body and make them feel amazing. Now that he offers the IDEAL IMPLANT® Structured Breast Implant, there’s no longer as much of a patient concern about safety risks and Dr. Sattler has the ability to adjust volume for a more symmetrical look. The IDEAL IMPLANT has lower rates of rupture and capsular contracture when compared to other implant options, which is why surgeons, like Dr. Sattler, love to recommend it to their patients. Get to know more about him, why he loves being a plastic surgeon, and what to expect if you select him for your breast augmentation.
Tell us a little bit about you and your practice.
“I’m Scott Saddler, a board-certified plastic surgeon in Seattle, Washington. I’ve been in practice for 13 years and, in conjunction with Joshua Cooper, another board-certified plastic surgeon, for seven years at our combined practice, which is called Sound Plastic Surgery. We are in Northeast Seattle, the heart of residential Seattle, a little bit north of the University of Washington. We operate at three different certified ambulatory surgery centers where we do all of our cosmetic breast surgery. Through the years, cosmetic breast surgery has been the number one thing that we do. We probably, between Josh and myself, do about five breast augmentations a week. I started using IDEAL IMPLANTS for the first time about two and a half years ago.”
Have you had any patients specifically ask for the IDEAL IMPLANT?
“I had a patient request the IDEAL IMPLANT specifically who had done way more research than I had. She just appeared in our clinic and wanted it and was motivated, so we placed them. I like to think I was one of the first people in Seattle to use the IDEAL IMPLANT. It fills the gap between patients that want an unstructured saline implant and patients that want the look and feel of a cohesive silicone gel implant. When patients want an IDEAL IMPLANT, they ask for it by name. So we’ve used several and patients look great. It is very difficult for me to differentiate between a patient that’s been augmented with silicone gel implants and the IDEAL IMPLANT. I have to reread my operative note if I see them a year or two down the line.”
Do you present the IDEAL IMPLANT as an option during a consultation?
“We do present it as an option now that we’ve used enough of them, and patients seem happy with them. Traditionally the discussion was either a single lumen, unstructured saline implant versus a smooth round silicone gel implant. Now, we do offer and recommend the use of a structured IDEAL IMPLANT. There’s a segment of patients that really feel motivated to use saline-filled implants, just based on their personal preference and the risk spectrum that they perceive that they’re exposed to when they’re undergoing augmentation.. I can tell you it’s been a long time since I placed a single lumen, unstructured saline implant. I just think the disadvantages are pretty substantial compared to the IDEAL multi-chambered implants.”
What does a typical breast implant consultation look like?
“It’s always part of my consultation to introduce the different types of implants. I like to give a brief history of implant use, at least since the early 2000s, because I think it puts a lot of the current choices in perspective. We pull out the smooth, round silicone gel implants and I always pull out a shape texture just to show people what we don’t use any more and explain a few of the things that I think are troublesome about those implants. We also have an IDEAL IMPLANT that’s prefilled that we bring out and patients can compare them to the smooth, round silicone gel implant.”
How does a typical breast augmentation procedure go?
“Breast augmentations are one of the types of operations where there’s a variety of things that can be done incorrectly. Over the years we’ve sorted out what delivers good results for our patients. We use a, for lack of a better analogy, Toyota improvement model, where there’s certain steps that we’ll always do because we know that it really improves our outcomes.
“The first thing I tell patients is that we always do this operation under general anesthesia. I feel the operation is accomplished efficiently in my hands in about 50 minutes under a general anesthetic. I always supplement that with local anesthesia so the patient wakes up comfortably. We always use a submuscular or dual plane position for any implant that we use because of the advantages or the lower risk of capsular contracture.
“We use an inframammary incision that I can hide right in the fold beneath the breast which provides a natural shadow and crease. After a year, that scar is basically invisible-you really have to go looking for it to find it. We never use a periareolar incision, nor do we use the transaxillary incision. I think there’s some problems with those scar positions, especially when you compare capsular contracture data to incision placement. An inframammary scar has lower capsular contracture rate than the other techniques.
“We do preoperative implant sizing with our female staff members to have a patient sort out what volume they’re going to use. We know when we go to the OR what implant volume we’re using. We always use, intraoperatively, a triple antibiotic solution, which has been shown to reduce the rate of implant infection and capsular contracture, pretty substantially. We don’t use a surgical drain. In the case of silicone gel implants, we use a Keller funnel. In the case of an IDEAL IMPLANT, there’s no need to do that. So we make a plan and then we execute the plan and we finish the operation really efficiently. Patients go home the same day and we see them back within a week of their surgery.”
How does a breast lift or breast revision work?
“For breast lift patients, we generally do a primary mastopexy augmentation which is a combined lift and augmentation. Same augmentation technique as mentioned above with a submuscular implant. The lift generally depends on how much ptosis or sagging the patient has, but it’s generally a superior pedicle vertical pillar technique, which I think provides some nice breast shaping. It eliminates lower pole sagging. Generally, we can get away with a lollipop type scar. Sometimes for patients with a lot of extra breast skin or breast tissue, we end up using a Wise pattern or an anchor pattern scar. So primary mastopexy augmentation is our go-to technique, single stage. I think we do a nice job getting good symmetry. I tend to recommend smaller implant volumes for breast lift patients.
“Placing an implant in the setting of a breast lift is really there just to impart some upper pole volume where patients don’t have it. We tend to stay away from large implants when we do a breast lift because of the tension on our breast lift wound closures. I make some pretty specific recommendations for implant volume for breast lift patients.”
Why did you choose to offer the IDEAL IMPLANT?
“I like IDEAL IMPLANTS because there’s a little bit more precision in volume that I can add to the implant. There’s two chambers and we can modify the volume in the anterior chamber to give the breast a bit more volume compared to the opposite side. In the IDEAL IMPLANTS I’ve done, that’s been one advantage where I could get a little bit of a better volume match compared to someone that’s using equal sized silicone gel implants. I’ve had a few patients in the past where I’ve used differentially sized silicone gel implants, and I’m always a little leery of doing that because the diameters of the implants themselves are different and therefore, you’re imparting a new asymmetry onto the patient. You’re trying to get more symmetric, but you’re using an asymmetric implant. The IDEAL IMPLANT, to my knowledge, doesn’t really change a whole lot in diameter if you overfill them, which is a good thing.”
What type of patients usually request the IDEAL IMPLANT?
“The patients that choose IDEAL IMPLANT have approached us and specifically requested the IDEAL IMPLANT. I think the decision to use an IDEAL IMPLANT was made before they entered our office, probably because of online research and the patient’s perception that a saline-filled implant is safer than a silicone gel implant. Patients come in with that mindset and I think the IDEAL IMPLANT is a perfectly safe device. I’ve gotten some nice results with IDEAL IMPLANTS. I’m increasingly, whole-heartedly recommending that implant when patients want them, especially if they have a bit of asymmetry that otherwise might be tricky to try to correct with differentially sized implants. My recommendation to some patients is not to try to chase perfect breast symmetry in terms of volume, because sometimes that can create other issues. However, if their asymmetry is mild, I think it’s worth using an implant, like an IDEAL IMPLANT, where we can actually micro adjust the volumes.”
Why do patients select you over other plastic surgeons in their area?
“We have really good reviews because our patients really like us. I think we have an aesthetic in our practice that is really natural. In other words, most of the patients in our market, which is metropolitan Seattle, don’t want a really augmented look. I’ve never really spent a whole lot of time pushing implants that I know will make a patient look augmented. The majority of our patients want to look very natural. Most of our sizing techniques are designed to deliver that really natural result. We pay a lot of attention to breast measurements in order to get really reproducible and as symmetric as possible results. I think you really have to pay attention to breast dimensions and overall tissue dynamics.
“You won’t get predictable results if you don’t really pay close attention to those numbers. Both my partner and I are board-certified plastic surgeons. We believe that’s the pinnacle of cosmetic surgery expertise in the world, actually. We’d like to think that our patients seek us out based on that. We’re also both nice guys, we’re both family people, we’re pretty approachable, normal, not flashy people.
“I also think they choose us because we have a small clinic. Our employees have been working with us for over seven years now, there’s very little turnover. I think they feel at home in our clinic. I can’t think of a better analogy than that, but it’s a pretty relaxed environment.”
What do you like about being a plastic surgeon?
“I really love it. It’s what I always dreamed of doing. I was a general surgeon for my first four years of medical practice. I trained at the University of Washington in general surgery. I then spent about five years in the Navy as a general surgeon taking care of mostly female dependents. I worked at the Naval hospital in Bremerton. I was doing a lot of breast surgery, which general surgeons do. I started working with some of the plastic surgeons at Madigan Army Medical Center, just south of Seattle here, down near Tacoma. I got to know a couple of those plastic surgeons and they said, ‘You act like a plastic surgeon. You should think about doing a plastic surgery fellowship.’ So that’s what I did when I got done with my Navy commitment.
“I did my plastics training at Oregon Health Sciences University down in Portland. Spent two years there, applied for my boards, took my boards, got my boards, and then moved back up to Seattle, started to practice. I think my training in general surgery led me into breast surgery. Doing a lot of breast surgery led me into plastic surgery, and that’s now mostly what I do. I really like delivering reliable, beautiful cosmetic results for patients. I love seeing patients happy. Nothing makes my day better than having a patient send us a note or give us a review that we did a great job and exceeded their expectations.
“At this point, the job is not as stressful as it used to be, because I think now we figured out what we’re good at, and we’re really good at cosmetic breast surgery. We deliver great results, but it took a while to arrive at that point in our career now, 12 years in. I feel confident when I walk into the operating room now. Today we did two breast augmentations and a lift. I know that patient’s going to end up happy. That’s a really great feeling at the end of the day, to know that you made that change in a patient’s life. It makes me sleep well at night.”
Considering breast implants in Seattle? Contact Dr. Sattler today to discuss your options. Simply call 206-729-2248 or visit soundplasticsurgery.com. Dr. Sattler’s office is located at 4915 25th Avenue NE #103a, Seattle, WA 98105. Call today for more information on IDEAL IMPLANT Structured Breast Implants.