At Vinings Surgery Center in Atlanta, Georgia, you can be positive that you’ll receive the best care by Dr. Robert Colgrove. He understands what women look for when it comes to treatments for their face, breasts, and body. We recently interviewed Dr. Colgrove to learn more about a typical consultation and his thoughts on the new IDEAL IMPLANT® Structured Breast Implants.
Tell us a little bit about you and your practice.
“I’ve been in private practice here in Atlanta since 1986. I’m board certified by the American Board of Plastic Surgery. We are located near the new stadium at interstate 285 and interstate 75.”
Why do you think women choose you?
“Women mainly choose our practice because of my extensive experience. I’ve done several thousand breast augmentations and breast lifts. Many patients that come in don’t realize they need a breast lift to get the correct result.
“We also offer the latest Vectra 3D simulation, which helps a patient visualize and understand what the various implants are going to look like. I also have an excellent staff, who’ve been with me for many years. Many of my staff have had plastic surgery, including breast implants. They’re very understanding and helpful as far as answering questions and getting you to feel comfortable with the process.”
Can you walk us through a typical consultation?
“When a woman comes in for a breast consultation, we begin with the Vectra 3D simulation. Vectra pictures will be taken, they’ll come back to the consultation room, then the nurse and I will go over the measurements and what we feel is going to be the definitive plan for this particular patient. We show them the various types of implants, along with the breast lift if necessary. Then my office manager will go over pricing, scheduling, the required blood work, and a preop visit can be scheduled if they so desire.”
Why is a breast lift only necessary in some cases?
“On the breast lift, we have measurements on the Vectra equipment that gives us a guideline. It’s just a guideline, we still have to look at the patient and see where they’re at. But typically if there’s a measurement of eight centimeters between the breast crease and the nipple, that’s typically too much for the implant to provide the necessary lift. Occasionally you can get away with it. Of course, I still have to see the patient in person and make a decision on that. But there’s the measurement, and then there’s also the elasticity of the patient’s skin. Obviously you have to examine the patient in person to determine that.”
How do you know which insertion approach to take?
“When a patient comes in we go over the various options for the insertion of the implant, you do have the axillary approach through the armpit, the areola approach, and the approach through the crease at the bottom of the breast. For most patients the crease incision is the favorable one. It heals the quickest, has the least amount of complications, and the quickest recovery. If you go through the areola area, obviously you have to go through some milk ducts, which could increase your risk of infection.
“Same with the axillary or armpit incision; there is a higher chance of infection. More pain, because you have to tunnel across from the armpit over to the breast. It’s a little harder on the patient because it takes more time for the patient to heal. Also, if they have an undesirable scar in the armpit, it’s impossible to conceal if they’re wearing a tank top or swimsuit.
“We’re certainly open to patients if they have a strong desire for one incision over the other. Some of our patients don’t scar well. Many of our Asian patient like the areola incision, because the scar is less detectable than the other areas.”
What are the long-term factors breast implant patients should consider?
“We tell the patient that they may need another procedure some point in the future, depending on several factors. Such as if they have a pregnancy after the procedure, that’s going to affect their breast. It may necessitate a breast lift at a later time. Also, the pocket of where the implants sit may change and have to be corrected.
“There’s a difference, we feel, between saline implants and silicone gel implants as far as the longevity and then need for further surgery. I tell my patients if they choose a saline filled implant and it doesn’t deflate, that they won’t have to change it. That’s assuming they don’t have a pregnancy, or rapid weight gain, or weight loss that would cause another problem.”
Why did you choose to offer the IDEAL IMPLANT as part of your practice?
“I’ve been doing this for 32 years and I’ve seen the pros and cons of the various implants. I think the IDEAL IMPLANT is going to cut down the need for future surgeries.”
How do saline and silicone gel implants compare with the structured IDEAL IMPLANT?
“The typical saline implant is basically water inside a bag and it tends to be causing more ripples and wrinkles for the patient. The silicone gel implants are softer and more natural, but then you have to deal with the silent rupture issue.
“That means that the patient and I don’t know if they have a rupture or not, unless we do an MRI or actually open the patient and look at the implant. We prefer not to do that if we don’t have to. The FDA has recommended that patients with silicone gel implants have an MRI after three years and every other year after that. It’s very expensive. I don’t think most insurance companies pay for it, therefore a lot of patients are more likely to go with a saline implant.
“The IDEAL IMPLANT offers the advantages of feeling more natural than the typical saline implant and feels a little bit more like the silicone gel implants without the drawbacks of silent rupture and the frequent MRI’s.”
Do you do any saline implants anymore, or do you mainly use the IDEAL IMPLANT?
“Well, patients will still sometimes use the regular saline implant just because of the cost situation. The IDEAL IMPLANT is going to cost more, but you’re going to get a better product.
“I think if they cost the same they’d probably go with the Ideal Implant every time, but we can’t really do that just because it is a more expensive implant. It’s a more complicated implant and it deserves to cost more.”
What has been your experience with silicone gel implant rupture?
“When silicone gel implants rupture, it becomes a very complicated procedure. Particularly, if they’ve been ruptured for a long period of time. I have seen patients that have had silicone gel implants for 30 to 35 years and probably been ruptured for many years. That takes several hours to take out the capsule and the silicone gel, which is basically free floating in the pocket.
“The capsule becomes very calcified and very painful for the patient. So, it’s a bigger surgery for the patient. You have to take out the capsule along with the implant, which means that there’s a need to put drains in for the patient and a longer recovery time. That’s the issue with a silicone gel implant that has been ruptured for a long period of time.
“Say you were getting the MRI for some other reason and you identified a rupture early. Then, you would still do a capsulectomy, but you probably wouldn’t have the calcification and the painful contractures.”
How does that compare to a leak with the IDEAL IMPLANT?
“With the IDEAL IMPLANT, if you need to change that out, you typically just remove the implant and put a new one in if the patient so desires. You don’t have to go through the process of cleaning up silicone gel because it’s filled with saline which is harmlessly absorbed by the body.”
How does this compare with handling a saline or IDEAL IMPLANT rupture?
“It’s a sterile saline that’s there and is easily absorbed by the patient. Most of the time there will be nothing there but the implant, which is easily removed. If you are changing the pocket, you may have to put a drain in.
“If there’s a deflation, patients usually call us on the phone and say, ‘Well, I was changing my clothes or putting my swimsuit on and noticed that my left breast or my right breast is smaller today. I need to come in and have it replaced.’
“They don’t have to spend money on an MRI, which is nice. It’s an easy diagnosis for them and for me. Again, it’s picked up early, not late.”
What would you tell other surgeons about the IDEAL IMPLANT?
“A plastic surgeon in Ohio who was my mentor called me up and said, “I see you’re using these IDEAL IMPLANTS. How do you like them? What kind of problems have you had with them and so forth?
“I told him the experience has been very good, it has been very positive for both the patient and me. I feel good about putting the implant in, because I know I’m helping these patients in the long run avoid issues down the road. They’re not perfect. Nothing is perfect, but I would say that when you look at them long-term and the patient is not having to worry about the silent rupture, I think it’s worth it to both them and me.”
How do you help women make their implant choice?
“When we’re doing the consultation, some patients come in and they think that they want silicone gel, but then we show them the IDEAL IMPLANT and explain to them the problems with silicone gel’s silent rupture and MRI’s. Most patients go with the IDEAL IMPLANT after they hear that. They like the safety aspect of it and they like the fact that they don’t have to come in every so many years to have the implant replaced.”
What has been your experience with the IDEAL IMPLANT as far as patient satisfaction?
“The patient satisfaction has been very good across the board. We haven’t had to go back in and remove them because they didn’t like them. I would say at this point it’s been very positive for the patient and the surgeon and continues to grow. It has basically overtaken my practice as the number one choice for breast implants.”
Anything else you want to mention about your practice?
“In summary I would like to say, here at Vinings Surgery Center, we have an accredited office surgery center where procedures can be done onsite. This makes it more private and confidential for you than going to the hospital. It’s going to be easier for you psychologically to have caregivers that understand why you’re here. A lot of my staff have breast implants so they won’t be judgmental. They will be supportive, which is helpful as far as giving you a positive experience.”
Considering breast implants in Atlanta? Contact Dr. Colgrove today to discuss your options. Simply call 770-955-9000 or visit www.colgrove.com. Dr. Colgrove’s office is located at 1900 The Exchange SE, Bldg. 300, Ste 300, Atlanta, GA 30339. Call today for more information on IDEAL IMPLANT® Structured Breast Implants.