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Dr. Constance Barone Explains How To Pick the Best Breast Implant

We asked San Antonio plastic surgeon Dr. Constance Barone to explain what options women have when choosing breast implants. Dr. Barone is a board-certified plastic surgeon with over 30 years of experience. She is a respected member of the medical community and known for her work as an innovator in plastic surgery, an author, and a teacher. Her extensive background, training, and work has resulted in her designation as one of America’s Top Doctors by multiple professional organizations, patient review sites, and media outlets. Recently she was named an IDEAL IMPLANT Premier Surgeon because she is one of the most experienced surgeons performing breast augmentations with the IDEAL IMPLANT® Structured Breast Implant.

Dr. Barone is dedicated to providing the safest and most efficient procedures for her patients. She also believes each patient should have access to a variety of choices in order to reach their goals. She offers every type of breast implant at her plastic surgery center and works to educate each patient about the benefits and compromises of each. Read below to learn what Dr. Barone has to say about choosing the best breast implants for you.

What Breast Implants are Available?

The FDA has approved 3 types of breast implants: saline breast implants, silicone gel breast implants, and IDEAL IMPLANT® Structured Breast Implants. At Dr. Barone’s plastic surgery center, you can see and feel each implant to help you make your choice. Before and after pictures are also available so you can see what the final results will look like.

  • Saline implants are filled with saline (saltwater), which is naturally and safely absorbed by the body if the implant ruptures. Saline has many medical uses, including filling IV bags to keep patients hydrated.  A rupture can be detected immediately because the implant will deflate as the saline flows out of it. These implants tend to visibly ripple and women complain that they feel unnatural, especially if they do not have much breast tissue or fat covering the implant.
  • Silicone gel implants have silicone gel inside the shell for a smooth and attractive result, but can give some women anxiety about potential complications. Silicone gel is not absorbed by the body, and it can be difficult to know if the implant has ruptured. Silicone gel has more recommended maintenance and a higher rate of complications than some other breast implant types. Many surgeons recommend replacing silicone gel breast implants every 10 years to avoid complications.
  • The IDEAL IMPLANT Structured Breast Implant is the newest breast implant type. Dr. Barone tells us, “it consists of a saltwater-filled structured breast implant. There is an outer fill valve, which covers the outer area, and then there’s an inner fill valve that covers the inner. So, there’s two actually fill sites, which allows this implant to have a very natural feel, as opposed to the saline implants, which felt hard and like a balloon.” The saltwater inside gives women peace of mind in the event of a rupture. It also has a low rate of complications such as capsular contracture and the lowest rate of rupture found in any breast implant.

How Does the IDEAL IMPLANT Structured Breast Implant Compare To Silicone Gel?

The IDEAL IMPLANT Structured Breast Implant was created to address common concerns with saline and silicone gel breast implants. Women should know about these concerns before they choose their breast implants. Dr. Barone explains the benefits and compromises of silicone gel breast implants, and how the IDEAL IMPLANT Structured Breast Implant compares.

“We like the feel of silicone gel implants. We just don’t like the fact that we should be getting MRIs at three years and every two years thereafter. That’s an out- of-pocket expense, which can be quite expensive. The other thing is, sometimes there’s silent ruptures. What’s that mean? That means it ruptures without you knowing it, and silicone gel leaks out. And what happens when that happens? Well, you can get a hard, calcified capsular contracture, and silicone gel can migrate. There have been studies that show silicone gel has been found in the livers of people who’ve had a silicone gel breast implant augmentation. The IDEAL IMPLANT is called a structured implant because it has little sleeves in this little shell, which allows it to have a buoyancy to it, so it feels more natural. It comes with a lifetime warranty. It also comes with a warranty for capsular contracture. We like the fact that this is a very, very user friendly implant and do you have to exchange it out? No. If you’re having no problems, it’s intended to be kept in place for a lifetime.” Overall, Dr. Barone believes the IDEAL IMPLANT Structured Breast Implant has many advantages over silicone gel breast implants and recommends them to women who want beautiful, natural looking results with peace of mind.

What Happens If a Breast Implant Ruptures?

What exactly is “implant rupture,” and how does it affect women? An implant can develop a small hole in the shell and begin to leak. In silicone gel breast implants, women may not notice a difference in their breasts, meaning the rupture is “silent” as Dr. Barone described above. Or they may feel a hardening or tightening, or feel lumps. As Dr. Barone mentioned, the silicone gel may migrate out of the breast capsule and into other parts of the body. In a recent survey of over 900 women 98% reported they would be somewhat concerned to constantly concerned about silent rupture with silicone gel implants. Before the IDEAL IMPLANT Structured Breast Implant was introduced many women felt they had to make the difficult choice between constant concern with silicone gel breast implants, and the unnatural feel of saline breast implants.

The IDEAL IMPLANT Structured Breast Implant can also rupture, but there is no risk of a rupture being silent. The saline inside begins to leak out of the implant and is safely absorbed by the body. A saline implant will deflate completely, leaving just the shell behind. Dr. Barone explains what happens when an IDEAL IMPLANT Structured Breast Implant ruptures, “one of the advantages of the IDEAL IMPLANT is that, if you get a deflation, it probably just deflates the outer sleeve so it’s not as obvious of a deflation.” This means that although you will notice a difference in your breasts, it will not be as obvious as with saline breast implants. You have the ability to plan a revision surgery around your life and your schedule.

The FDA recommends every type of implant be removed and replaced if a rupture occurs. The IDEAL IMPLANT Structured Breast Implant can easily be removed and replaced by your plastic surgeon. Silicone gel breast implants can be more complicated to remove after a rupture, especially if the silicone gel has migrated away from the breast capsule. The FDA explains what happens if silicone gel begins to travel outside the breast capsule, “The leaked silicone gel may cause lumps to form in the breast or in other tissue, most often the chest wall, armpit or arm. It may be difficult or impossible to remove silicone gel that has traveled to other parts of the body.”

How Do Breast Implants Compare Aesthetically?

Saline breast implants are often compared to water balloons because they are simply a silicone shell filled with saltwater. They are not as dense as breast tissue, and tend to ripple under the skin. This can be a problem especially in women without much breast tissue or fat to cover the implant. Dr. Barone tells us “I was very excited when the IDEAL IMPLANT came out because one of the things I hated, and most women hated, about the saline implant was just the unnatural feel. They felt like balloons underneath the chest wall.” The internal structure of the IDEAL IMPLANT Structured Breast Implant gives it a smooth, natural looking result that many compare to the look and feel of silicone gel breast implants.

Dr. Barone tells us about the aesthetic benefits of the IDEAL IMPLANT Structured Breast Implant as compared to silicone gel breast implants. “One of the other advantages of the IDEAL IMPLANT is the fact that it’s got a nice contour to it. It’s not super high profile, so you don’t get that real full upper pole, but it’s a more natural look. The other advantage is that there’s less rippling associated with IDEAL IMPLANT. I know everybody says that silicone gel implants don’t ripple, but guess what? They do. There’s rippling associated with both types of implants, but I feel far less with the IDEAL IMPLANT.” Aesthetically, the IDEAL IMPLANT Structured Breast Implant gives women the natural, beautiful results they want.

How Does Dr. Barone Present Choices to Patients?

Patient choice and education are very important. No patient should ever feel pushed into a decision they feel uncomfortable with. Dr. Barone tells us how she presents breast implant options to her patients. “When people make their selection in my office, I present all types of breast implants to them. I present to them the adjustable breast implant. I present to them the silicone gel breast implant. I present to them the IDEAL IMPLANT. And I present to them the saline implant. Why do I do that? I think that’s an important part of an informed consent. So, a woman can make their own decision as to what type of implant they want. I give them brochures on all different types of breast implants so that they can do their homework and they can study on it. I’m an investor in IDEAL IMPLANTS because I believe in this implant. I think it’s a great choice for women who want a breast augmentation. Because, if it does leak it’s only saltwater. I don’t try to influence my patients. I let them make the decisions as they feel, and look at the implants. But I also tell them the pros and cons of all the implants. For breast augmentation, I think the IDEAL IMPLANT Structured Breast Implant is the choice today.”

How Should Women Choose a Plastic Surgeon?

Women should know it is important to choose an experienced board-certified plastic surgeon to perform your breast augmentation. A board-certified plastic surgeon has spent years training and performing plastic surgery procedures, learning about every complication and how to get the best possible outcome. Additionally, to maintain board-certification by the American Board of Plastic Surgery physicians must meet continuing education requirements and take exams periodically.

Dr. Barone is board-certified in plastic surgery, so her patients know from the first meeting that she is dedicated to providing safe and effective medical care. Her patient reviews reflect her level of professionalism and her compassion. Read what some recent patients had to say about their experiences below.

“I was very satisfied and comfortable discussing my options with the doctor. She was very attentive to my needs and met all expectations, always very friendly and professional. I love the new me and highly recommend her to make you happy.”

www.RealSelf.com user liviaodabachian

“Excellent doctor and staff! Very caring, they take time to answer questions and follow up. Would recommend to anyone! I have been coming here for years. What a difference it has made in my life and confidence.”

www.Google.com user Ruby Rupprecht

“Dr. Barone is the best of the best and I am very happy with my results. I highly recommend her to my family and friends. Go see her!”

www.Facebook.com user Carmen Pazmino

If you curious about plastic surgery, visit Dr. Barone’s website to see what procedures she offers in addition to breast augmentations. She is trained in “awake” surgical technique for patients who feel uncomfortable with full sedation. Dr. Barone’s office is a state of the art plastic surgery center and features a spa facility, a laser center, an outpatient center for cosmetic surgeries, and rooms for treatment and recovery. Her patients enjoy a relaxing environment that allows them to discover their full potential. Don’t wait to start on your journey to a new you, your only regret will be that you didn’t start sooner!

Considering breast implants in San Antonio? Contact Dr. Constance Barone today to discuss your options. Simply call 210-614-0400, or visit baroneplasticsurgery.com. Dr. Barone’s office is located at 9502 Huebner Road, Building 2, Suite 202, San Antonio, TX 78240. Call today for more information on IDEAL IMPLANT® Structured Breast Implants.

Your Grand Rapids Breast Augmentation. Before and After photos from Dr. Steven Ringler

Toronto Plastic Surgeon Explains Why He Recommends the IDEAL IMPLANT

IMPORTANT NOTE: Below you may find untouched before and after photos of patients who have granted permission to their surgeon to show them anonymously. While we protect the identities of our patients, please be advised that by their nature, these photos contain sensitive content. Read more

Dr. Larry Nichter on the Benefits of the IDEAL IMPLANT® Structured Breast Implant

Dr. Larry Nichter is a board-certified plastic surgeon in Newport Beach, California. A formerly tenured professor at the University of Southern California, Dr. Nichter now runs a successful private practice, Pacific Center Plastic Surgery in Newport Beach, with fellow surgeon Dr. Jed Horowitz. Dr. Nichter is a lead FDA investigator for IDEAL IMPLANT and has presented reports on the success of this new technology to the American Society for Aesthetic Plastic Surgery and American Society of Plastic Surgery. After nine years and over 100 cases using the IDEAL IMPLANT® Structured Breast Implant, Dr. Nichter has a unique point of view. We asked Dr. Nichter about his thoughts and experience with breast implants. Read below for his expert opinions.

What are the benefits of using the IDEAL IMPLANT® Structured Breast Implants?

“Well from a surgeon’s perspective, the best thing involved is you don’t really have to worry about silent ruptures. So silicone gel implants have a rupture rate that’s pretty high from 9% – 24% at 10 years. If silicone gel implants are ruptured, it’s not simply removing the silicone gel, you usually have to remove the capsule around the gel, the lining around the gel, called a capsulotomy. And that takes extra time, that can take half an hour to an hour per breast to do that.

“That’s in comparison to the IDEAL IMPLANT® Structured Breast Implant where if it leaks, you just simply remove it. Because of the high rupture rates, I tell my patients for silicone gel implants, just plan on removing them every 10-12 years, because after that the rupture rate is so high. You don’t have to do that with IDEAL IMPLANT® Structured Breast Implants. You can just leave them in until there’s a leak because it’s just simple saline, the stuff that’s in an IV solution. It’s incredibly safe and so there’s far fewer lifetime surgeries with an IDEAL IMPLANT® Structured Breast Implant, compared to traditional silicone gel implants.

“There are also many uses for the IDEAL IMPLANT® Structured Breast Implant. For example, it’s not just for primary augmentations, you can also use it for revision work, especially if the patient has had problems in the past with capsular contracture. In fact, the IDEAL IMPLANT® Structured Breast Implant has this incredible guarantee that they will give you in terms of replacing implant and helping the patients should a complication occur. It can be used not just in revisional surgery but at the same time as we do a breast lift.

“And lastly, although it’s not FDA approved for reconstruction during mastectomy, I do think in the future, once it’s FDA approved, this will be a great addition to our arsenal for reconstruction after breast cancer.”

Have you had to deal with many ruptured silicone gel implants in your career? What other complications could lead to a revision surgery?

“Oh yes. Ruptured silicone gel implants are just part and parcel, what we call bread and butter surgery for a plastic surgeon because of the high rupture rate. The other reason we operate on patients with silicone gel implants, and saline implants for that matter, is capsular contracture, that is, the hardening of the implant. The implant actually is soft, but the membrane around it, called the capsule, gets very thick and can actually squeeze the implant, distorting the way the breasts look, so making it quite hard.

“We were very surprised, in the FDA study looking at more than 500 woman, how low the capsular contracture rate was for IDEAL IMPLANT. In fact, it was significantly lower than silicone gel implants, which in the past had some of the lowest rates. So, that’s a huge advantage, another advantage of the IDEAL IMPLANT® Structured Breast Implant.”

How is patient satisfaction with the IDEAL IMPLANT® Structured Breast Implant?

“Part of the FDA study is looking at satisfaction. The women’s satisfaction is somewhere between 92- 94%, almost identical to what the surgeon’s satisfaction rate is. So they’re extremely thrilled with the results.

“My patients in general are thrilled about IDEAL IMPLANT. In fact, they tell their friends and their friends come in for it and so on. It’s very interesting that two studies were done last year. One of which looked at a very large volume of woman, more than like 930 woman. And they did a study and wanted to know, ‘Would you be concerned if there was a silent rupture of an implant, say a silicone gel implant? Or any type of implant. But if so, would you want it removed?’ Overwhelmingly, more than 90% said absolutely we would want it removed.

“I’m not sure if you’re aware of this, but the FDA has guidelines for silicone implants, their guidelines are very specific. They would like you to have an MRI scan at three years, and then every two years to see if you have a rupture because if you have a rupture of silicone gel implant, typically you don’t see any difference with your breasts so you would not know this. Women are very concerned about that fact. They don’t like having it and this survey, done by a third party, show that over 90% of the women, if it was a silent rupture, they wanted the implant removed.

“With an IDEAL IMPLANT® Structured Breast Implant, since it’s just saline that fills it, it’s wonderful. Instead of an MRI scan, you just simply use a mirror. But you can keep your implant not just 10-12 years, which is what I recommend for silicone gel implants, but for 20 years, 25 years. As long as it’s intact and okay. If there are no silent ruptures, that’s a huge advantage.”

Have you noticed any recent trends in plastic surgery?

“Well certainly the time is right to consider a more advanced breast implant. Women are health conscious, they’re looking for things that are natural and very healthy. There’s nothing more natural or healthy than saline. That’s what your body is filled of. So, that’s one of the reasons why I think the IDEAL IMPLANT appeals to many people.

“Many people are looking for organic foods and things, again, that have very low health risks. They don’t want to have to have lots of studies, like the MRI scan. For example, you have to make an appointment. It’s expensive. It’s not covered by insurance. You have to take time out of your life. And there’s worry. What are the results? What happens if it’s ruptured? The peace of mind factor is huge for patients, for women in particular. And here you have a natural product that’s just saline. If it ruptures, it’s just like getting an IV, you’re hydrated.

“But the bottom line is, it fits all the criteria of a more natural, healthy alternative to a silicone gel implant. And I see that as a huge trend.”

Have you noticed a change in the size breast implant women are requesting?

“Yes. So I’ve been doing breast augmentation surgery, using breast implants for reconstruction, lifts with reconstruction, mommy makeovers, for 30 years. During my first 10 years, every year implant size seemed to get larger and larger and larger in terms of requests by my patients. The middle 10 years, it seems like they mostly, slowly got a little larger. But the last 10 years, clearly women are moving towards smaller implants.

“They want something that’s proportionate. They either want to dress up and look very sexy or they would like to get in business clothes and be taken very seriously. They’re more athletic, again, health conscious and they want something that will fit many different aspects of their life. Again, the IDEAL IMPLANT is great because one advantage of the IDEAL IMPLANT, for example, is you can adjust the volume. So if you have breast asymmetry, you can get more symmetrical breasts. You can affect the profile.

“So you could have a more aggressive, more sexy looking sort of profile if you wanted to. Or you can have a very natural appearance. You have all the advantages of this, unlike silicone gel implants where you have to be very specific on which implant you pick. So you have the options on the operating table of changing the characteristic slightly to both match in size and shape, and also patient’s desires.”

Do your patients have any concerns about scarring after surgery?

“One advantage of the IDEAL IMPLANT® Structured Breast Implant is the implant is placed into the body deflated and then once it’s in the pocket, it’s inflated and filled. Because it’s deflated, you can use a much smaller incision, so therefore, there’s less scarring involved with the IDEAL IMPLANT. A silicone gel implant, in comparison, is factory-filled without seams and so in order to have an implant that’s sizeable, unfortunately, we need to make an incision that will accommodate it. So that’s a big advantage, there’s far less scarring with the IDEAL IMPLANT.”

What are your views on implant placement (above or below the muscle)?

“We take every patient on an individual basis. We ask them a lot of detailed questions. We have them bring in pictures of what they would like to look like. So a lot of women that have very little breast tissue, for example, and would like to be subtly improved, or to increase the fullness on the upper part of their breasts, which in general is the place where you lose volume with aging and, especially after pregnancy, we oftentimes will put it beneath the muscle.

“But there are other reasons. If someone has a little bit of sag and does not want a lift, putting the implant above the muscle or splitting the difference in what’s called a dual plane, where it’s partially under the muscle and partially over, can help augment and lift the breast a little bit. So there are many nuances and that’s why it’s really critical that you got a board-certified plastic surgeon such as myself, that has this experience and all the nuances in order to do the best job.

“The IDEAL IMPLANT company, I have to give them tremendous credit. The IDEAL IMPLANT company is [one of] the only implant companies that will sell to only board-certified plastic surgeons. So you know if you’re choosing IDEAL IMPLANT, just by choosing it, you know you’re at least going to someone with significant training and experience to get the results you want. And they will spend a lot of time with you and, hopefully, as we do, to make sure that you know all the choices, nuances of where to place the implant. Above or below the muscle and so on. Where scars will be. Whether you need a lift at the same time. And so forth.”

What complications do women need to be aware of before getting breast implants?

“So, when we’re looking at implants and you’re comparing different types of implants, in particular, let’s compare IDEAL IMPLANT® Structured Breast Implants to silicone gel implants. First of all, if you’re under the age of 22, only saline implants are FDA approved, so that would limit it to IDEAL IMPLANT. Virtually no one uses the traditional, old fashioned saline implants because the waviness or rippling and so on.

“But in terms of risks we already went through, there’s two to four times less risk of rupture and again, at least a two-fold decreased risk of capsular contracture with the IDEAL IMPLANT. Those are the two main complications.

“There are some rare, or I should say uncommon complications that are making the news. One of which is ALCL: Anaplastic Large Cell Lymphoma. It’s a cancer that’s not very aggressive, but the point is, although it’s been linked to several types of implants, it’s my understanding that approximately 80% or more are only found in textured implants. There’s a rough surface around the implant and that’s of interest. It’s the most common implant used outside the United States, especially in Europe, South America, and Central America. This form of cancer, especially with certain brands of implants can be significantly high. As much as 1 in 5,000, or less as time goes on, because it takes many years, at least eight to ten years or so, for most of these to develop.

“But the IDEAL IMPLANT® Structured Breast Implant is a smooth implant, so that would put you at the least possible risk. To my knowledge, there’s never been a report of ALCL with any implant by the IDEAL IMPLANT Company. We’re now up to year nine in our study, which will end at 10 years. So it’d be the lowest of all the rates in developing this unusual type of problem.”

How do you help women choose the right breast implant?

“Choosing implants is a difficult choice and we understand that. We’ve made a pretty simple chart comparing, on one side, silicone gel implants, and saline implants, particularly the IDEAL IMPLANT® Structured Breast Implant, on another. So, for example, incisions are smaller with the IDEAL IMPLANT® Structured Breast Implant. There is less risk of capsular contracture (that’s the hardening of the implant). And less risk of rupture, significantly between the two. There’s no silent rupture. You don’t have to worry about, ‘Is it ruptured or not?’ You know immediately. Therefore, we don’t recommend that the IDEAL IMPLANT® Structured Breast Implant is replaced 10-12 years, unlike a silicone gel implant. You can keep them in as long as you want. So therefore, there’s less lifetime surgeries.

“Then lastly, again, we just let them know that the contents are just saline. It just leaks out. If there was a rupture with a silicone gel implant, chances are you would need to remove the outer lining around it, which is a much larger procedure and may require drains and so on. That’s just not required with the IDEAL IMPLANT® Structured Breast Implant.

“But it used to be that about 90% of my patients, up to 95%, would pick silicone gel implants, and maybe only 5% saline. Now, it’s easily the majority of my patients pick IDEAL IMPLANT® Structured Breast Implants after I present that information and allow them to read about it. And I’m thrilled.

“Here you have something with all the advantages of a silicone gel implant, without the disadvantages. So, it’s a win-win situation. My patients usually are very well educated. Many of them find me because I have some of the largest experience in the country placing these. And they come to me with that specific reason. If they haven’t heard about them I just mention, ‘why don’t you do some research? Here’s some scientific articles reviewing it.’ They make the decision really quickly and they’re in a very informed way. Invariably, the majority now pick IDEAL IMPLANT® Structured Breast Implants.”

Do you have any advice for women who are considering breast enhancement surgery?

“Well first of all, the most important decision you can make is to pick your surgeon. The second most important choice you can make is to pick the safest product to use, or one that matches your wishes, goals, and ideals.

“So one, you have to pick a board-certified plastic surgeon. But I have to tell you, I work in Newport Beach, Orange County, Southern California. And I would think that at least half of the implants placed in my area are placed by non-board-certified plastic surgeons. What do I mean by that? Ear, nose, and throat doctors are doing it in this area. OBGYNs are doing it. General surgeons are doing it.

“And doctors don’t know. They say very truthfully, ‘I am a board-certified surgeon, doing plastic surgery.’ Dermatologists are even starting to do these. A plastic surgeon trains longer than just about every speciality out there with the exception of a few, like neurosurgery, cardiothoracic surgery. They train about the same length of time.

“So you really want someone who is skilled with both the anatomy and function, and all the potential problems that could go wrong, which fortunately are very few. But in terms of getting a result that’s excellent, you just need to pick that right person.

“The second thing is that many surgeons feel comfortable with what they trained with. The IDEAL IMPLANT has only been around for just under five years. So although there is a very large experience which is growing significantly and dramatically, sometimes surgeons are set in their ways. So it behooves patients to sometimes even educate their doctors. Say, ‘I’ve been reading about this implant. I think I would like to use it.’ And to encourage their doctors if they don’t know about it, to find out about it. It’s very simple to use. But I think that I can just see the rate of which the growth is happening with the IDEAL IMPLANT, and my personal prediction is within the next 5-10 years, it’ll be one of the more popular implants in the U.S. and Canada.”

What can you tell us about your plastic surgery practice?

“I’m part of a two plastic surgeon practice in Newport Beach, California, called Pacific Center for Plastic Surgery. In this office, we place more IDEAL IMPLANT® Structured Breast Implants than, I believe, just about any practice in the United States. As one of the lead FDA investigators, I’ve read through most of all the peer reviewed journal articles on the IDEAL IMPLANT, and that takes everyone’s experience, all the 45 investigators of all the women patients across the country, and I have access to the data that’s been published. I’m just thrilled with the results.

“I think that going to someone who has lots of experience is always one of the best choices you can make. Fortunately there are plastic surgeons across the entire United States that have that experience. We of course would welcome anyone to our practice, to educate them about their choices, and in particular about the IDEAL IMPLANT.”

Considering breast implants in Newport Beach? Contact Dr. Larry Nichter today to discuss your options. Simply call 949-720-3888 or visit www.PacificCenterPlasticSurgery.com. Dr. Nichter’s office is located at 3991 MacArthur Boulevard, Suite 320/340, Newport Beach, CA 92660. Call today for more information on IDEAL IMPLANT® Structured Breast Implants.

Dr. Joshua Waltzman on Breast Augmentation, Silent Rupture, and Why He Likes IDEAL IMPLANTS

At Waltzman Plastic Surgery in Long Beach, California, you’re in the capable and experienced hands of board-certified plastic surgeon Dr. Joshua Waltzman. A Long Beach native and USC alum, Dr. Waltzman offers both invasive and noninvasive treatments for the face, breast and body. In a recent interview, he spoke with us about his practice, the breast augmentation process from start to finish, and the new IDEAL IMPLANT® Structured Breast Implants.

Why should patients choose your practice over others in the area?

“Women choose our practice because they feel very comfortable here. I’m the only surgeon, and our staff is small. Patients aren’t walking into this overwhelming office with multiple doctors and clinicians and equipment surrounding them. When they walk in, they feel like they’re coming into our family. Patients will talk to the staff and get to know each other’s families. We really do have a sense of community here that distinguishes us from other practices. My staff and I also spend a lot of time with our patients. I am deeply invested in listening to all of my patients’ concerns and goals. When it comes to breast augmentation, there are a lot of specific things women are looking for that are important to hear and discuss before the surgery takes place. So I think taking the time to listen also sets us apart.”

Who makes a good candidate for breast augmentation?

“Someone who is in good health, doesn’t smoke, has breasts that sag or have lost volume, these are all women who are good candidates for breast augmentation. Most women who come in want to have bigger breasts, and I try to explain that an augmentation alone will simply make you a natural, larger version of what you are. So, if your breasts are naturally close together, after an augmentation they will still be naturally close together, just bigger. And on the flip side, if your breasts are naturally spaced a little bit further apart, your augmentation will make them larger, but they will still be spaced the same distance apart.

“If women are desiring to have other changes made, whether it’s making the nipple position higher, making the breasts smaller, or changing the overall architecture or shape, then we have to talk about other procedures in addition to augmentation alone. Typically, my patients are moms who are done having children, they have some volume deflation from the breasts after breastfeeding, which is natural, and also some descent or lowering of the nipple position. And in some of those cases, we have to combine a lift, either at the same time, or before doing an augmentation.”

Can you guide us through your specific breast augmentation process?

“It all starts with a physical exam. Taking really detailed measurements of the patient to customize their augmentation or their implant selection choice is paramount. Beyond that, we talk about implant placement. We talk about why I might choose to place the implant above or below the muscle. Of course, that’s influenced by the patient’s starting breast size and how much soft tissue, or how much breast they initially begin with.

“Another choice we make is the location of the incision. I prefer to do most all of my primary augmentations (meaning first time breast augmentations) through what’s called an inframammary approach, which is a small three- or four-centimeter incision tucked right in the breast fold. There is a lot of data that shows that this approach leads to lower capsular contracture rates, lower infection rates, and it gives the surgeon a much better view of the implant pocket when you’re designing it. It’s really the best approach for breast augmentation. The scar is always there, but it fades quite nicely. And when it’s in that fold, it really is a non-issue. Now, if a patient comes to me and has pre-existing scars from elsewhere on the breast, whether it’s an areola scar or elsewhere on the breast, I’m happy to use those. But my preference is for an inframammary approach.

“We talk about all the different types of breast implants out there, and discuss which one the patient might have a preference for. The patient’s physical measurements will help dictate implant selection to a large extent. We also talk about what their goals are. Are they just looking for a subtle natural enhancement? Or are they looking to revolumize what they have lost after pregnancy and breastfeeding?

“In my office, I like to use a 3D simulation software. I scan all the patients in the exam room during the consultation. It takes about 30 seconds. And on the iPad, right there, we can do a full 3D simulation and start trying on different implant sizes with pretty good accuracy. That’s been a great way for patients to picture how they will look with a certain pair of implants. It’s one thing to see implants on a before and after picture of someone else. You may not know anything about them. They might have a different frame. Before and after photos usually mean very little to a patient, until they see how the implants will look with their own skin markings, freckles, etc. If they have a tattoo, that will also be in the 3D simulation, and that really drives it home for them.”

What are your thoughts on silent rupture with silicone gel implants?

“I’ve had multiple patients who have experienced some type of silent rupture. The more common scenario is that I find the rupture during an implant exchange and/or upsizing or downsizing. I discover it once I am operating on the patient, which is really the ultimate silence. It wasn’t identified with any preoperative imaging, so my patient didn’t even know about it.

“With older silicone gel implants, the gel can be pretty messy. It’s much stickier, it tends to run. Getting all that gel out requires additional time in the operating room. With some of the newer generation silicone gel implants, the gel is more cohesive. If there’s a rupture, the implants tend to come out quite a bit easier. But obviously, with saline implants, that’s not an issue. You know right away if there’s a rupture, and in that case, you’re only spilling a little bit of saltwater into the breast cavity which easily gets absorbed harmlessly by the body.”

Why do some surgeons still push silicone gel implants on certain patients?

“Silicone gel may be the right choice for patients who have very thin tissue coverage. So, either they’re very thin patients, or their breast tissue has been stretched, and their breast tissue coverage is very thin. For women with this thin breast tissue coverage, they may be able to feel a more obvious difference between silicone gel implants, saline implants, and the IDEAL IMPLANT.

“So that’s one thing I bring up for patients that are very thin. But I always try to give my patients the option that they are most comfortable with. Sometimes my patients will say, ‘Oh my sister had saline, my aunt had saline, my mom had saline. I’m having saline,’ and there’s not even a discussion to be had.

“I think educating my patients and presenting all their options, including the risks and benefits of each one is always the way to go. At least that’s how I do it in my practice. And there are certain patients who will push for one direction or the other, but for the vast majority, it really is kind of a decision for both of us.”

What are the the benefits to the new IDEAL IMPLANT technology?

“There are many benefits to the IDEAL IMPLANT. My experience with the IDEAL IMPLANT has been only positive. I routinely present it, during all of my breast augmentation consultations, as a third option. For breast augmentation we have silicone gel, regular saline, and then we have the IDEAL IMPLANT, which is a structured saline implant. The IDEAL IMPLANT is surrounded by a silicone shell, but it’s filled with saline. The inner shells provide more structure to the implant, and the inner baffling on the shells helps prevent that water balloon effect that women with saline sometimes complain about.”

How can a woman know if there is a leak or rupture in her IDEAL IMPLANT?

“With traditional saline, once an implant is popped or ruptured, it’s completely gone. It’s more of an all-or-none type phenomena. That creates some aspect of emotional distress because the woman will have one breast that is fully inflated and the other will be completely deflated. And that could be troublesome for finding bras and clothing, going out, all these things, until you have the implant fixed. The IDEAL IMPLANT brings peace of mind to a lot of women. If there’s a problem with your implant, you’re going to know fairly quickly. You’ll notice some deflation, but due to the dual chamber nature of the IDEAL IMPLANT, it’s unlikely that both the front and the back chamber of the implant are going to become ruptured at the same time, so you won’t lose all of your volume. This can buy the woman some time before she actually needs to have the implant fixed.”

What types of patients can benefit from the IDEAL IMPLANT?

“Patients who are good candidates for the IDEAL IMPLANT are those who are looking for a fuller, rounder breast look. The IDEAL IMPLANT gives women a moderate plus-to-full kind of profile if you equate it to the silicone gel equivalents. If a patient wants to fill out a deflated breast pocket, I also think the IDEAL IMPLANT is a great option.”

What has been your experience in terms of patient satisfaction with the IDEAL IMPLANT?

“Patient satisfaction after IDEAL IMPLANT has been incredibly high. I’ve had no patients come back saying they wish they’d picked another implant. I present data to my patients on the lower rupture rates and lower capsular contracture rate for the IDEAL IMPLANT. This data gives my patients even more peace of mind. I’ve had a number of IDEAL IMPLANT patients who have actually slept good, based on that data alone. I haven’t had anyone complain of the IDEAL IMPLANT rippling like other saline implants tend to do. Overall, I’ve been very impressed with the positive feedback I’ve received on IDEAL IMPLANT. My thought is, since we have this new breast implant technology, why not use it?”

Considering breast implants in Long Beach, CA? Contact Dr. Waltzman today to discuss your options. Simply call (562) 448-6100 or visit www.waltzmanplasticsurgery.com. Dr. Waltzman’s office is located at 3828 Schaufele Avenue, #360 Long Beach, CA 90808. Call today for more information on IDEAL IMPLANT Structured Breast Implants.

Want a Breast Augmentation? Dr. Thomas Hubbard’s Patients Feel Confident about the IDEAL IMPLANT

Did you know that there is a new type of breast implant available to those seeking a breast augmentation? Now women don’t have to only choose between saline or silicone gel implants. Dr. Thomas Hubbard, a plastic surgeon located in Virginia Beach, VA, and board-certified by the American Board of Plastic Surgery, discussed in a recent interview the differences and advantages of this new, innovative structured implant: IDEAL IMPLANT® Structured Breast Implants.

Can you describe your practice and primary focus as a plastic surgeon?

“I’ve been in practice for 25 years now. Breast enhancement surgery has been a big interest of mine, and a large portion of my practice throughout my career. I’ve always had an emphasis on breast surgery. I joined a surgeon who developed possibly the most important technique in breast surgery – the ‘no-touch technique.’ I was with him almost six years. And with that technique, I’ve got my capsular contracture rate down one in many hundreds. But that’s not the only important thing with breast surgery, there are many parameters that need to be controlled, adjusted, and it’s all about pleasing the patient and getting what she wants.”

How do you help women beginning the breast augmentation process determine implant size, implant placement, and incision location?

“All of my implants are placed beneath the muscle. The advantages are numerous: lower rate of capsular contracture, quality mammograms, more natural appearance. I think with age it works out better in the long run as well. And then a recent study even showed that women with implants above the muscle, when they get breast cancer, it’s more advanced. There are so, so many advantages to going beneath the muscle.

“Regarding the choice about incision, most of mine are inframammary. I use a sleeve, whether I’m using saline or silicone gel, which helps with the capsular contracture rate being extremely low, but especially with silicone gel since it helps with the smaller incision in the inframammary area.

“For all my 25 years, I’ve been using sizing. We have several sets of sizers in the office, and a staff member spends plenty of time with each woman where she tries on different sizers in a bra with a top on, looking in the mirror, until she finds that look that she’s looking for. Now I tell her, ‘I don’t know whether that’s a Double D or a C. In fact, one company’s D is another company’s C. So, that really doesn’t matter. I want you to be comfortable with that look, you’ll find out later what the cup size is.’ We also have the Vector System 3D Imagery that we use. That’s a big advantage. It helps women preview the result. It’s nice to have the 3D imager because all of the implants, all the brands and types are programmed in. Sizing preoperatively is extremely valuable for getting those proportions that you want.”

How do you help women decide between traditional saline implants, silicone gel implants, and IDEAL IMPLANT® Structured Breast Implants?

“I have found that women choose, some with my help and some based on their friends, they choose an implant type and I really don’t see many regrets with the implant type. Maybe because they’ve made up their mind and they’re going to stick with whatever they’ve decided. Maybe because we have done a very good job of educating them about the pros and cons, and they’ve worked it through.

“There are some women who have made up their mind before they come in. I’m happy to go along with their choice. All my implants are smooth. I’ve never done the textured implants, so I don’t have to worry about the lymphoma that is related to textured implants. So if you want silicone gel, fine. If you want saline, that’s fine.

“Now, there is a sizable portion of women who have not made a decision and I’m happy to provide unbiased information. I tell them there is no implant that’s perfect and then I go on to describe the three types of implants – silicone gel, saline, and the IDEAL IMPLANT® Structured Breast Implant. I talk about the pros and cons of all.

“I had practiced many years before silicone gel implants were available, so there was quite a big change when all the silicone gel became available for women age 22 and older. My experience with saline was so good that I didn’t necessarily go to pushing silicone gel, and I still don’t go to pushing silicone gel. I still feel a woman needs to know the pros and cons of all of them, and I’m not going to tell a woman that she needs to go to silicone gel for sure or saline for sure.

“Now some women are better candidates for silicone gel and some women are better candidates for saline. For example, if there is a woman who is 5’10”, 105 pounds, you can see her ribs with very little breast tissue, she’s a Double A or Triple A, I am actually going to suggest to her silicone gel. She has very little padding, so her whole breast is the implant. But a woman who is even a B or a C, even some As, that have enough tissue, they can enjoy the benefits of saline as well. But they need to make that decision.

“If I were to summarize women who are choosing the IDEAL IMPLANT, I’m going to say I think they get it. They get it because they are looking through a lot of hype, a lot of different opinions on the Internet, and they’re seeing that saline has the same happiness rate as silicone gel. There are some long-term benefits of a saline implant: lower capsular contracture rate, less concern over time, and no need to get MRI scans.

“So, in choosing the IDEAL IMPLANT, they get it. The IDEAL IMPLANT is less likely to get visible rippling. It has a more natural feel. And it’s going to have that extremely low capsular contracture rate, which with saline, one in hundreds and hundreds and hundreds gets capsular contracture.”

What if a woman is concerned about implant rupture or wrinkling?

“If you’re really worried about rupture, if it’s something causing your anxiety, if you’re going to find yourself worrying about the silicone gel and “Should I get the MRI?” or wonder if it’s ruptured, maybe you should be considering saline. And if you’re considering saline, look at the rupture rate of the IDEAL IMPLANT. If the leak rate is a concern to you, the IDEAL IMPLANT leak rate is not even half the rate of other implants. So that is a big advantage of the IDEAL IMPLANT.

“As far as rippling goes, I think rippling rates are greatly exaggerated. If you look at the actual studies on rippling rates, the rate is pretty low unless you’re really, really thin. But if it’s a concern and you’re going the saline route, then look at the benefits of the IDEAL IMPLANT as far as rippling rates go.”

Should a woman be concerned about implant rupture?

“I don’t think women that think it’s not a problem are completely informed about the situation. Yes, you can take a ‘gummy bear’ implant, slice it on a table, and really there doesn’t appear to be anything flowing. But then there is an implant that is under the muscle getting squeezed and smashed and squeezed and smashed all day long with all our daily activities. Things don’t stay that way, so the inside silicone gel does get out.

“And in fact, since very few women actually end up getting the MRI scans, there’s a growing number of plastic surgeons who are recommending that a woman just go ahead and switch out her silicone gel implants at 10 years. At that point you probably have about 8% leak rate and with an 8% leak rate, it’s probably time to switch it out and put new implants in.

“Now with silicone gel implants, you’ve got to think about cost. I do inform women that if they’re choosing the silicone gel route, it’s safe and a good implant, but think of long-term cost with the silicone gel as well. Also, there are many of us who believe that it can lead to a capsular contracture at a later time. Women need to consider that you’re not going to know when you have a rupture. A sign that your implant has had a rupture that could have happened years before, is that your breast has turned firm and hard. That’s a capsular contracture. We do everything we can to avoid a capsular contracture.”

How soon after surgery can women return to their regular exercise routines?

“I feel strongly about some recommendations I make. No exercise for three weeks. Why? This goes back to the capsular contracture rate. We want it one in hundreds and hundreds. We don’t want to see capsular contracture more than every few years. And that’s one, and that’s in my opinion, too many. We want it at almost zero.

“How do you do that? Well, a lot is on the surgeon with the technique. I change my gloves multiple times during surgery. I use a sleeve no matter what I do, and you can go on and on with that.

“After surgery though, some woman bring up that their friend did exercise at a week. Well, but up to three weeks you can have a little bit of bleeding. You may not know about the bleeding, but a little around the implant can increase your rate of capsular contracture. This is an investment for the rest of your life. You want it to go extremely well, so we do need to go three weeks without exercise.”

How do women typically feel about the outcome of their breast augmentation?

“I actually do research on satisfaction rates with breast surgery. This is one of the highest happiness rates of any operation out there. Yes, silicone gel and saline have the same happiness rate. It’s very high. So whether you go with silicone gel or saline, you’re likely going to be quite pleased. The bottom line is you’re probably going to be happy with your choice.”

Do you conduct any other research?

“I’m doing research on controlling the settling of implants. I think there are ways to control the settling of implants. Did you know that when a surgeon puts the implants in, they sit a little high initially? They look a little funny initially, since they sit too high. Then they drop for six to seven months. It’s so out of the control of surgeons as to what happens during that six to seven months. Where they’re going to go is where they’re going to go.”

What should women look for in a plastic surgeon?

“I think she needs to make sure that breast surgery is one of the primary focuses of the surgeon that she’s going to see a consultation with. Reputation is very important as well. That makes a big difference. I would pick a surgeon who is offering saline, silicone gel, and the IDEAL IMPLANT. And why is that? Because all women are different. All women have different goals. Why would a surgeon exclude a class of implants that have the same happiness rate. A surgeon should offer all three implants, because all women are different. Their goals are different, and I think it’s important.”

Considering breast implants in Virginia Beach? Contact Dr. Thomas Hubbard today to discuss your options. Simply call 757-687-1900 or visit www.hubbardplasticsurgery.com. Dr. Hubbard’s office is located at 329 Phillip Avenue, Virginia Beach, VA 23454. Call today for more information on IDEAL IMPLANT® Structured Breast Implants.

An Interview With Dr. Scott Greenberg: Questions for Your Plastic Surgeon and the IDEAL IMPLANT

Dr. Scott Greenberg is a board certified plastic surgeon in Winter Park, Florida who has over 25 years of experience in cosmetic surgery. Former patients of Dr. Greenberg appreciate his attentiveness, his professionalism, and his dedication to meeting their individual goals. We recently sat down with Dr. Greenberg and discussed his practice, breast augmentation, and IDEAL IMPLANT® Structured Breast Implants.

Tell us a little about your background and experience.

“I’ve been in practice here for close to 20 years and I practiced in New Orleans for 10 years prior to coming to Winter Park. My training is initially in general surgery. I completed a plastic surgery residency in Norfolk, Virginia, and then I did a fellowship after that in pediatric plastic surgery and maxillofacial surgery at the Akron Children’s Hospital in Akron, Ohio.”

What percentage of your practice focuses on breast surgery?

“About 75% of my practice is breast surgery and that runs the gamut from augmentation to reduction to breast lifts, etc. We perform a lot of implant exchanges and removal and replacements as well. We see patients who want a lot of “bodywork” done, including massive weight loss patients and body lifts.”

What other procedures do you specialize in?

“We offer all the cosmetic medicine treatments including injectables, Botox, fillers, as well as having extensive laser treatments and surgery. Our practice is really able to offer everything from A to Z. When a patient comes in and requests a consultation for a particular problem, we have all the tools here that we need to to correct that.”

Why should patients who are seeking breast surgery come to your office?

“I have many years of experience in breast surgery and I’m able to perform procedures in an accredited in-office facility. In fact, nearly 100% of our surgical procedures are done in the office. We can also accommodate patients who need to stay overnight if the particular situation demands that, too. Most patients really appreciate that convenience. Our staff is dedicated and well trained. We do a lot of the same procedures day-in and day-out, so we are very efficient and skilled at it. If a post-surgery complication arises, we can reduce the cost of additional surgery because everything can be taken care of in our facility. If this were not the case, patients would have to go to a special surgery center or a hospital and incur significant additional expenses.”

How do you help your patients decide on the right type and size of breast implant for their body?

“Unlike other surgeons, I don’t have my patients try on different implants in their bra or take a lot of measurements. In my experience, these methods are not effective. Just because two women measure the same, they may not want to look the same. So, I usually draw them a series of drawings to show how we can control not only breast size, but breast shape with successively increasing sizes of round implants. Our patients can bring in photographs of breasts they like and breasts they don’t like, but we recommend that they go to our website where they can look at photos of patients who have had breast augmentation. We have pictures taken from the front and the sides. I ask my patients to especially look at the side views. It’s been my experience that if we can get the upper pole of the breasts the way a patient wants in terms of the amount of fullness, then they will be happy.

“We go over those photographs at the preoperative consultation which is two weeks prior to surgery. Then we go over them again immediately before we walk into the operating room and that gives me a clear idea of exactly what they want. I tell my patients not to get caught up in letters or numbers when it comes to the cup size they want. Most patients leave the implant selection up to me to get to their individual goal. Women are not going to care about what the size of the implant is as long as they walk out of the shower, look in the mirror, and are happy with how they look. That’s worked very well for me for the last 20 years.”

What has been your experience in managing silicone gel implant rupture in patients?

“Since I have been in practice for close to 30 years, I have had a lot of experience dealing with the pre-1992 implants. These were made with thinner shells and runnier gel and that was a big mess. With the more recent silicone gel implants, the damage of the ruptures tends to not be quite as extensive because the gel is more cohesive. When a patient decides on a silicone gel implant, I let them know there are some risks. Silent rupture is much less likely with the newer generation gel implants than the previous one, but it does happen. I want my patients to be comfortable with the implant choice they make. There is a risk of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) with textured implants, so we don’t offer those any longer.”

What are some questions patients should ask or some things they need to know before choosing a plastic surgeon?

“A patient needs to know that their surgeon is going to stand behind them and be available to them no matter what. A good plastic surgeon will take their time with you and not rush you through your initial appointment. If you go to a surgeon who gives you five minutes during a consultation when they’re trying to solicit your business, how much time do you think you’re going to get when you have a complication?

“Patients should absolutely make sure their surgeon is board-certified, so they can feel confident knowing their doctor has the experience, knowledge, and judgment to help them meet their goals. All board certified plastic surgeons are members of the American Society for Plastic Surgeons, but you should also look for a board certified plastic surgeon that is a member of the Aesthetic Society. That indicates a particular expertise and interest in cosmetic surgery. A board-certified plastic surgeon may just do hand surgery and may not do breast augmentation all that often. Patients should also find out where a particular surgeon operates. I think that my patients feel much more comfortable actually being in an office surgical facility because by the time they come in on the day of surgery, it’s the third time they’ve been here. They come for the initial consultation, they come for a preoperative consultation two weeks prior to surgery, and then they come for the day of surgery. So their surgery is taking place in a familiar room with familiar faces and it’s much less anxiety provoking.

“For women who are wanting breast augmentation in particular, you have to ask your surgeon about their experience with breast surgery. You should ask questions like:

  • How many breast surgeries have you done?
  • How many breast surgeries do you perform in a month?
  • What is your experience with complications?
  • How are complications handled?
  • Who is expected to pay for complications?  

“One of the most important things a patient should also think about is how they feel they’ve been treated by the office. If they call the office and they speak to someone who’s affable, who can give them information, who’s interested in not just soliciting their business but giving them an educational experience, I think that speaks well for the whole process. Last, most all plastic surgeons now have websites and personally I would look for a website that is more of an educational site than a promotional site, because I feel strongly that that’s what it should be.”

What percentage of women that you see are choosing IDEAL IMPLANT® Structured Breast Implants?

“We’ve really just started using the IDEAL IMPLANT in the last month or two. I’ve done just a couple of cases, so it’s obviously a smaller percentage of my practice now. The IDEAL IMPLANT is great for that woman that still has some concerns about the safety of silicone gel. For that woman who has had multiple operations with multiple different types of implants this may be a great option for her. In my experience, if a woman wants the safety of saline without the risk of silent rupture, but she doesn’t like how a traditional saline implant feels, then she is an ideal candidate for the IDEAL IMPLANT.”

Why have you decided to include IDEAL IMPLANT in your practice?

“I want to be able to offer my patients all the best options that are out there. It’s important for patients to be well educated about their choices, so they can work together with their surgeon to pick the implant that works best for them. When a patient holds these implants they can figure out if the IDEAL IMPLANT is best for their particular situation and comfort level. The IDEAL IMPLANT feels really close to what a silicone gel implant feels like, with the safety profile of saline.”

Considering breast implants in Orlando, FL? Contact Dr. Scott Greenberg today to discuss your options. Simply call 407-499-8154 or visit www.scottgreenbergmd.com. Dr. Greenberg’s office is located at 1925 Mizell Avenue, Suite 303, Winter Park, FL 32792 . Call today for more information on IDEAL IMPLANT® Structured Breast Implants.

A Chat With Alexandria Plastic Surgeon Dr. Eric Desman About Breast Enhancement Surgery and the IDEAL IMPLANT

Dr. Eric Desman has been providing highly personalized care to residents in the Northern Virginia and Washington, D.C., areas since he opened the Virginia Center for Plastic Surgery in 1999. He greatly enjoys getting to know his patients and building an ongoing relationship with them. Dr. Desman’s practice is focused on body contouring procedures such as breast augmentation, tummy tuck, and liposuction.

Why should patients choose your practice over other options in the area?

“At the Virginia Center for Plastic Surgery, we help our patients achieve a natural and not overdone look. I help each individual figure out what that means for them, and I do my best to help them achieve their plastic surgery goals.”

Have you seen any changes or trends when it comes to breast implants?

“In general, people are much more educated about breast augmentation and what goals are attainable. Patients get a lot of information from the internet. There’s pretty good information out there, but my job during your consultation is to find out what’s important for you specifically so you can make a good decision for yourself.”

What is your approach to helping women pick the right breast implant size?

“A 300cc implant is going to look vastly different in a woman who is 5’ 1”, 105 pounds who’s never had any children compared to a 5’ 7”, 147 pound woman who’s had 2 or 3 kids. Those women are very different in body physique and tissue type. So, during the course of a consultation, we’ll take some measurements of your breast tissues. This helps me see if what you wish to get out of breast augmentation is an achievable result. Some women who want a certain breast implant size have enough breast tissue to achieve that size and some don’t. Taking these measurements gives us the ability to pick the best type and size of implants for your body. We spend a lot of time prior to surgery trying to pinpoint your desired outcome post-procedure. As a surgeon, I can tell by looking at your body frame and looking at a volume number what we can expect in the range of cup size. Since there is no such thing as a standard cup size, most women are after kind of a full C, small D range. If you come in for your consultation and want to have exactly the same procedure as your best friend, that may just not be right for you. I try not to focus so much on cup size, and really hone in on the final look my patient wants.”

What should women know before choosing a plastic surgeon?

“You’ve got to look at the surgeon’s years of experience. You should also take into account how their office staff responds to you, because that is almost always a reflection of the doctor. Throughout the course of your surgery, you will sometimes have as much contact with the office staff as with the doctor in the day-to-day visits. So if the office staff treats you well, that’s a good sign. Then once you make it into the office, think about how closely you feel you’re being listened to. Some of it is a little bit of a gut instinct, a gut feeling to make sure that the practice and the surgeon are a good fit for you personally.”

Can you talk to us about placement of the breast implants? Is above or below the muscle better?

“With a breast augmentation surgery, there are two basic choices of where to put the implant. One is above the muscle and one is mostly below the muscle. The very bottom part of the implant is typically not below the muscle, but the upper two-thirds to three-quarters of the implant are covered by the muscle. I like to go below the muscle as there’s a little bit more of a natural feel to the touch. Mammograms are also easier to read if the implant is under the muscle. So most women choose to go underneath the muscle and typically that’s my recommendation unless there’s any special extenuating circumstances that would indicate a need to go above the muscle. Depending upon what type of implant you choose, you have a lot of options on placement of the incisions. I discuss that with my patients throughout the whole process so we’re on the same page.”

How can women speed along the healing process after breast surgery?

“One of the things that we do at the Virginia Center for Plastic Surgery that has been very successful over the past 15 years is a rapid recovery approach to breast augmentation surgery. This rapid recovery approach allows most women to get back to normal activities, (sore but functional), 24 to 48 hours after surgery. There are three things that allow us to get most women back to normal activities very quickly after surgery:

  1. We pick the right implant for your body.
  2. We use a meticulous surgical technique that allows very little bleeding which helps the recovery process.
  3. We ask the patient to come in and complete arm stretches after surgery which will also help hasten her recovery.

“My approach to rapid recovery breast augmentation means there are no special bras or narcotics needed after surgery. You can get into the shower the night of your procedure and women love it because they can get back on their feet very quickly.”

What can you tell us about silent rupture in breast implants?

“Breast implants are man-made devices. They’re not lifetime devices. So every implant, in my opinion, eventually will leak or rupture. If you have silicone gel implants and you detect a rupture early enough, a lot of times we’re able to remove the implant as well as the scar tissue that surrounds the implant as one unit. But frequently that leak in the silicone gel implant is not detected quickly and the silicone starts to leak through that scar tissue. A patient will then need a challenging, complicated surgery to get that old implant out and then put a new implant in. If the patient puts new silicone gel implants back in, then they’re just restarting the clock on the next problem or process with a leaked silicone gel implant. With IDEAL IMPLANT® Structured Breast Implants, it’s easy to detect a leak because the breast will just start to get a little bit smaller as the saline leaks out. If that does happen, then it’s a fairly straightforward operation to replace that implant.”

What do you like about the IDEAL IMPLANT?

“From a surgeon’s perspective, I like the IDEAL IMPLANT because they have a fill range and that gives us a lot of control in the operating room for sizing of the implant. Most women have a bit of asymmetry, so we’re able to even that out during a breast enhancement procedure. The IDEAL IMPLANT also has a great feel to the touch after surgery and gives women a very natural look. Combine that with the lower capsular contracture rates and lower rupture rates that come along with IDEAL IMPLANT and these are all things that really make it a nice device to work with. Most of my patients are choosing IDEAL IMPLANT® Structured Breast Implants for these reasons over silicone gel implants.”

What do your patients think about the IDEAL IMPLANT?

“We’ve been using IDEAL IMPLANT for almost a year now, and my patients have been very happy with the results. They’ve been very satisfied with their look, and it’s equalled or exceeded their expectations. With IDEAL IMPLANT® Structured Breast Implants, I see this trend continuing for a long time.

Considering breast implants in Alexandria, VA? Contact Dr. Eric Desman today to discuss your options. Simply call 703-982-7106 or visit www.vcps.com. Dr. Desman’s office is located at 6355 Walker Lane, Suite 510 Alexandria, VA 22310. Call today for more information on IDEAL IMPLANT® Structured Breast Implants.

Your Breast Plastic Surgery in Massachusetts with Dr. Russell Babbitt

At Plastic Surgery of Southern New England, Dr. Russell Babbitt believes it’s an honor and a privilege to provide quality and compassionate medical and surgical care. He says, “Helping my patients achieve their goals is a rewarding and fulfilling experience. My door is always open for all of your questions and concerns.” If you are considering breast plastic surgery in Massachusetts, book your consultation with Dr. Russell Babbitt. Patients describe him as “amazing,” “awesome,” and accommodating.” He is excited to offer his patients the newest in implant technology: IDEAL IMPLANT® Structured Breast Implants.

Your Options for Breast Implants

You can’t make an informed choice about your breast implants unless you know all your options. For breast augmentation, women can choose between three different types of implants: saline, silicone gel, and the IDEAL IMPLANT.

Saline Implant: A saline breast implant is a silicone outer shell that is filled with a sterile saltwater solution (saline). Saline implants can have either smooth or textured shells. Saline implants are approved by the FDA in women age 18-years old or older. Saline implants do tend to ripple under clothing, creating a “wrinkling” effect, and some patients describe them as feeling like water balloons. Dr. Babbitt says, The nice thing about the traditional saline implant is that, since it’s filled with saline, if there’s a rupture, women know right away. There is never a silent rupture with saline implants.” When looking at their options for breast plastic surgery in Massachusetts, many women choose saline implants.

Silicone Gel Implants: These breast implants also have a silicone outer shell, but that shell is filled with silicone gel. Like saline, they can have either smooth or textured shells. According to the FDA, only women who are 22-years old or older can use silicone gel implants, but they do recommend that you receive an MRI to screen for silent rupture three years after receiving your implant and every two years after that. It is impossible to tell if your silicone gel implant has ruptured from the outside. Sometimes MRIs are still not 100% accurate when screening for silent rupture. Dr. Babbitt says, “Some patients are more concerned about a natural feel or have poor tissue quality, so they tend to choose this option.”

IDEAL IMPLANT Structured Breast Implants: These implants were invented by a plastic surgeon and approved by the FDA for women 18-years old and older in November 2014. They are filled with saline and have an internal structure consisting of a series of nested shells. These shells support the upper pole when the implants are upright. These implants have a natural feel and no risk of silent rupture, which is why many women choose IDEAL IMPLANT for their breast plastic surgery in Massachusetts. Dr. Babbitt says,In my mind, the IDEAL IMPLANT is the best of both worlds. It has the shape and the feel and the projection that you associate with a silicone gel implant, but it comes with the peace of mind that you associate with a saline implant. For many patients that really does strike the best balance between peace of mind and aesthetic result.”

The Risk of Rupture with Breast Implants

When you compare the top 3 brands of silicone gel implants and their rupture rate at 6-7 years for primary augmentation, you’ll see that the average rupture rate is around 5%.

  • Allergan rupture rate: 7.4%
  • Mentor rupture rate: 3.4%
  • Sientra rupture rate:  5.4%

Though that may seem low, IDEAL IMPLANT has a much lower average rupture rate at 7 years of only 1.8%. Also, if your IDEAL IMPLANT does rupture, it won’t go flat like a regular saline implant will. Dr. Hamas, the inventor of the IDEAL IMPLANT, explains how this works,

“The IDEAL IMPLANT has a series of nested shells, (3-5 depending on the size) with two separate lumens or chambers. The inner lumen is filled through a valve on the back, and the outer lumen is filled through a valve on the front. Because there are two chambers, the implant won’t go flat if one chamber deflates. So, unlike a saline implant, a replacement can be scheduled electively. The internal structure supports the edge so that it does not wrinkle, and supports the upper pole, so that it does not collapse when upright. In effect, the internal structure supports the shell of the IDEAL IMPLANT.”

Sometimes an implant will rupture and you have to undergo additional breast plastic surgery in Massachusetts to remove the implant. If you have silicone gel implants, the surgery can be complicated and take more time. With the IDEAL IMPLANT, rupture removal surgery is simple and can be stress-free. Since there is no sticky silicone gel leaking out of your implants, your body will just absorb the salt water and your implant can be replaced quickly.

The Look and Feel of the IDEAL IMPLANT

Since the IDEAL IMPLANT technology is relatively new, many women have never held the implant or felt its consistency. They also don’t know how it feels compared to a saline implant or silicone gel implant. Women may worry that it won’t look and feel as natural as other implants that have been around longer. Dr. Babbitt says,

“Many patients that come to see me for breast plastic surgery in Massachusetts have never even heard of the IDEAL IMPLANT. It’s kind of fun to see their reaction when they find out that something does exist that has all the benefits that the IDEAL IMPLANT does. When it comes to breast augmentation surgery, patients’ most important criteria are that we are able to achieve a natural look and a natural feel. The IDEAL IMPLANT allows us to achieve that just as well as a silicone gel implant does. And I really think that that is a major advantage for my patients, if not the most important advantage.”

Unlike saline implants that bounce up and down like a water balloon when dropped, the IDEAL IMPLANT behaves more like a silicone gel implant and maintains its structure. Many patients who choose the IDEAL IMPLANT like its youthful shape and natural feel. After a six-year clinical trial on the IDEAL IMPLANT, 89.7% of patients said they were completely satisfied with their implants, and in a recent independent survey conducted in 2017, 78% of nurses and 74% of doctors reported they would seek out IDEAL IMPLANTS after learning about them.

Patient testimonials and statistics continue to show that the IDEAL IMPLANT is a great choice for breast plastic surgery in Massachusetts.

The Education and Experience of Dr. Russell Babbitt

After graduating from the University of Massachusetts Medical School in 2003, Dr. Babbitt trained in Plastic and Reconstructive Surgery at the UMass Medical Center. In addition to his clinical training, Dr. Babbitt completed a two-year research fellowship in the areas of microsurgery, human anatomy, limb reconstruction, complex models of wound healing, and abdominal reconstruction. He is board-certified and specializes in all forms of cosmetic and reconstructive procedures, including breast plastic surgery. In Massachusetts, Dr. Babbitt is one of the exclusive surgeons in the Fall River area to offer IDEAL IMPLANT® Structured Breast Implants.

Considering breast implants in Fall River or researching breast plastic surgery in Massachusetts? Contact Dr. Russell Babbitt today to discuss your options. Simply call 508-567-3202 or visit www.plasticsurgerysne.com.Dr. Babbitt’s office is located at 300 Hanover Street, Suite 1A, Fall River, MA 02720. Call today for more information on IDEAL IMPLANT Structured Breast Implants.