Do you want a breast implant that allows you to achieve a natural look and feel, similar to a silicone gel implant, but also comes with peace of mind of a saline implant? The IDEAL IMPLANT® Structured Breast Implant is a new, innovative choice available to women seeking the advantages, without the drawbacks, of those traditional types of breast implants. In a recent interview, board-certified plastic surgeon Dr. Adam Hamawy of Princeton, NJ, talked about this unique option.
What do you discuss with women that are considering a breast augmentation?
“I spend a lot of time with my patients. If someone’s coming in for a breast augmentation, they’re here for at least an hour. For the first part of it, we are just talking, seeing what you’re trying to achieve, where you’re at, what’s bothering you. But the next part is the education. I always like to talk about five decisions you need to make with the breast augmentation. We need to decide, is it just a breast implant that we’re looking after or do we also need to do a lift. We also talk about where we are going to put the incision, where we are going to put the implants, what size of implant, and what type of implant.
“Those are five things everyone has to decide, and in order to decide them properly, you need to be educated even if you think you’ve done all your online research. There are so many different things out there. Even if the patient has seen other surgeons, I like to cover everything to make sure we are complete. Once you have all that information, the pros and cons of each one of them, then you can make a proper decision.
“I always tell everybody, ‘You have a lot of tools, and you have to be able to use all these tools to get the best results.’ It’s usually not just one surgery or one technique or one device that will get you to your goals. And by being a plastic surgeon, I have access to all of these and can do a surgical procedure. I have access to different breast implants. We could do fat grafting in addition to implants. If we’re doing breasts, same thing with devices. I don’t have one device that does everything. That’s why I love being a plastic surgeon. We get to talk and tailor results, really tailor them, to what you actually need for your body and your goals.”
How do you help your patients decide on the type and size of breast implant that will be best for them?
“I have a silicone gel implant, I have a saline implant, and then I have the IDEAL IMPLANT. I give them those in each hand, and then say, ‘Feel this.’ Feeling it in your hands is one thing, having it behind your skin and your tissues is a completely different thing. So I apply something over them and say, ‘This is what it is going to feel like in your body.’
“As part of every visit, there is an examination. During the exam, I’m looking at a few things. I’m looking at dimensions, how wide the chest is, how wide each breast is. I’m looking at asymmetry. Everyone’s asymmetric, but some are more asymmetric than others. So if it is within physiological limits, where you can’t really tell unless you look closely, then we’re talking about putting the same size implants in.
“Also, we’re looking at how much skin and breast tissue we already have that you could cover an implant. So someone who is very thin with very little breast tissue, that will factor into our decisions like whether we are going to go over or under the muscle and what kind of implant we are going to place. We’re looking at your actual muscle there, that pectoral muscle. Some people are doing these really hard workouts in the gym, and we’re going to start considering going above the muscle rather than below. These are all individual things that we have to take into account when we are deciding what kind of implant to place and where to place it.
Some patients will choose one or the other based on how they feel. But if I give them all that information, then together we can make a decision, rather than me telling them, ‘This is what I want to do for you.’ We are making that decision together.”
What do you tell your patients about the IDEAL IMPLANT?
“I’ve been working with the IDEAL IMPLANT maybe two or three years. I came across it at a plastic surgery meeting, and they were talking about a better saline implant. Initially I said, ‘Well, who needs another saline implant when everyone’s going with silicone gel.’ But when you place them side-by-side, it’s definitely an option that fills in a gap.
“I tell everyone who’s coming in, if they’re worried about breast implants, ‘This is the most studied device that the FDA has ever looked at, more than anything else.’ But there’s still a certain sense of security when telling someone that we’re going to put in a saline implant that’s going to feel almost as good as the silicone gel, and also give the security of being able to know if it’s ruptured right away. So the IDEAL IMPLANT fills in that gap for people who are still worried about silicone gel, want a natural result, and don’t want the rippling that comes with a traditional saline implant. I tend to find that although most people are happy with traditional saline implants, it does have some issues with rippling and a little bit less natural look in some patients. I haven’t found that to be at all a problem with the IDEAL IMPLANT.
“Plus, the safety record that the IDEAL IMPLANT has so far has been excellent from what I’ve seen personally, as well as in the plastic surgery community.”
What is your advice to women after they receive a breast augmentation?
“Follow your recovery instructions, and follow up with your surgeon. Don’t disappear. Your body heals and changes over time, so I usually like to see people one week later, one month later, and three months later. Then an annual check up with your regular physician, as well as your plastic surgeon, is important as well. You should be doing your self-breast exams. You should be doing mammograms if you’ve reached that age where it’s recommended. You should be taking care of your breasts just like you would if you didn’t have implants.”
What are the potential complications women should be aware of following a breast augmentation?
“The most common complication we see with breast implants is mal-position; this is when one’s a little bit higher or a little bit lower than the other side, something called capsular contracture. Capsular contracture is basically a capsular around a breast, scar tissue that forms around the implant. Just like you can have a scar on the outside, you’re going to have a scar on the inside, and most of the time this is not something that you can see or feel. Everyone has that. But just like some people have poor scars on the outside, you can have a poor capsular on the inside, and that’s when there could be a problem. That’s when it could be a little bit tight, it could be a little bit painful, and it could often move the implant from where it’s at. So, if we notice that two or three months later, that the implant has shifted or there’s a tightness that shouldn’t be there versus the other side, that’s something that can often be fixed, either in the office or in the operating room. We remove the capsule and things are made normal again.”
What should women know about the possibility of implant rupture?
“If an implant ruptures, then we need to change that. One good thing about the IDEAL IMPLANT is that if it’s ruptured, you know right away. You’ll look like you have a deflated implant, a flat tire on one side. It’s filled with saline, and your body will absorb that. You go to your doctor, and he’ll schedule to have that removed.
“With silicone gel implants, it’s a little bit different. They can rupture, but it doesn’t go everywhere, it doesn’t go anywhere at all. What it tends to do is stay in that space. It might cause that capsule we were talking about to form a little bit harder, so it might feel a little bit different, it might look a little bit different, or might be a little bit painful. There’s nothing specific in that case. You actually have to get either an MRI or an ultrasound to confirm that there’s a rupture there.
“The newer silicone gel implants are a lot better than the earlier generation. So right now, if I have a ruptured silicone gel implant, it’s easy to take out. You go in there and pull it out, and there is very little residue that’s left over depending on how old it is. If you have a silicone gel implant that’s over ten years old, it’s a little bit more difficult, especially with the older generations. It could take sometimes hours to get all that leaked silicone gel out.
“Really the issue comes down to detection. Is it ruptured or not? You could have a fall or an accident, something feels different, and there’s a lot of worry that goes with that. Is it ruptured or not? And having a saline implant eliminates that. There’s really no question. I get women who say they have a saline implant, and they come in and say they are worried that it’s ruptured. I just look at it and I can tell them yes it is or it’s not. I don’t need anything more than that. With silicone gel implants, it does take more than that.”
What characteristics should women look for in a plastic surgeon?
“You want someone that is going to give you options, not someone that’s telling you, ‘This is what you have to do and that’s all I do, all the time. I just do silicone gel implants. Or I just do implants that go under the arm.’ If someone does just one thing, then they’re probably not tailoring it toward you. So one consideration is to see how many options they are giving you.
“Two, see how much you are being involved in the conversation. Are they actually sitting down with you, talking to you, giving you different choices and educating you so that you are coming to a decision together?
“And, three, I encourage people to shop around. I don’t think you need to see a million doctors, but I think maybe two or three. It gives you a sense of perspective and even if you like your first doctor more than anybody else. When you go to someone else, it’ll secure your decision and you’ll know, ‘I like that person, and now I know why.’ When people come and tell me I’m going to see a few more other people or I’m seeing someone else, I encourage that. It makes me secure that you’re a little bit more educated, that you know what’s out there, and what you are getting.
“So, go look around. Find a plastic surgeon that is board-certified. Find someone who offers the IDEAL IMPLANT, even though you might not want one. For example, if you wanted the silicone gel implant and you know you don’t want the IDEAL IMPLANT, well maybe it’s at least worth a feel. If they are giving you the choice, even if you don’t choose it, that’s a good thing. Look for choices, and make sure you are looking around at other doctors. Make sure you are comfortable. This is someone that you’re not just going to be seeing at the surgery, but afterwards. You want that relationship, that bond, to be there. That’s very important as well.”
Considering breast implants in Princeton? Contact Dr. Adam Hamawy today to discuss your options. Simply call 609-301-0760 or visit www.drhamawy.com. Dr. Hamawy’s office is located at 106 Stanhope Street, Princeton, NJ 08540. Call today for more information on IDEAL IMPLANT® Structured Breast Implants.