The Feel of Silicone Gel, the Safety of Saline: IDEAL IMPLANT with Dr. Jonathan Heistein

As a plastic surgeon certified by the American Board of Plastic Surgery, Fort Worth worth plastic surgeon Jonathan Heistein is part of an exclusive group of surgeons eligible to offer the IDEAL IMPLANT® Structured Breast Implant to his patients pursuing a breast augmentation. In a recent interview, he discussed the benefits of this new, innovative structured implant.

What are the different breast implant options available?

“Over the years, breast implant technology has changed a little bit. The choice for many, many years was either the standard saline implants or the newer silicone gel implants. Now we have a third option, which bridges the gap and has some of the best properties of both worlds. The IDEAL IMPLANT is a structured implant and so it offers the ability for the implant to maintain its shape a little bit better than a saline implant would, yet has some of the better qualities of silicone gel in terms of it being softer and more natural feeling.”

How do you help your patients decide what type of implant is right for them?

“When a woman comes in for a breast augmentation consultation, in addition to discussing all of the pros and cons of each of the styles of implants, I allow them to feel each one, see each one, and see how each one looks on them. They are able to try them on. I present the data in an unbiased way, so that they can see what the literature says about the implants in terms of the rupture rate and contracture rate. It gives people who want to have that information a better understanding of what they are choosing.

“Many women come in unsure of the kind of implant that they want. Some have heard good things about silicone gel, and some have heard bad things about silicone gel. They may have preconceived notions about one of the other. But if I present them an unbiased opinion and give them the facts about each one of those, many women are now choosing the IDEAL IMPLANT as a viable option, which can give them some of the properties of a saline that make it better and some of the properties in silicone gel that make it better.”

What happens when a woman with silicone gel implants experiences a “silent rupture” and wants to change her implant type?

“In general, when a silicone gel implant ruptures, it can be problematic. But for women who don’t want to deal with the problem of not knowing that they’re ruptured, then a saline or a ‘structured implant’ might be a better choice. When there’s a ruptured implant and an exchange is planned, I don’t think that the style of implant going back in really has much of a change of the outcome. The majority of the operation, the hard part of operation, is making sure that all the implant, implant material, and sometimes scar tissue, is removed appropriately. But once that groundwork has been laid, the process of putting in that new implant is pretty straightforward.”

How do you help women determine the cup size that will best fit their body?

“Determining size is one of the most important things we do at the consultation for a breast augmentation, because that is ultimately what determines the outcome. First, I find out what each patient’s goals are. So if they’re a B cup bra, and they want to end up something like a D or a C, that can give me a basic idea of where we should start. The first thing I do is take some measurements. That’s important to understand the dimensionality of the implants, and how they’re going to look and function. It also allows me to help decide which implant might look most natural based on those dimensions. Once we’ve determined the dimensions and what would fit and what wouldn’t, I allow patients to try on the different sizes in a bra that we provide for them. They look in the mirror and see what they look like and feel what they look like. This way they can really see what they are getting into with each volume.”

Why do you like the IDEAL IMPLANT® Structured Breast Implant?

“As a surgeon, the IDEAL IMPLANT offers some advantages over both saline and silicone gel. The biggest advantage is that it’s useful for women who worry about having a ‘silent rupture’ with a silicone gel implant. So the IDEAL IMPLANT, like saline implants, if there’s a rupture, it will deflate and you will know it right away. The other thing that’s very nice about the IDEAL IMPLANT is that it maintains the shape of the implant like a silicone gel implant would due to the structure that’s inside the implants. It combines the best of both worlds because there’s no risk of ‘silent rupture’ and there is no need for frequent MRIs. That’s also another added benefit that women like in choosing the IDEAL IMPLANT.”

What kind of response do you get from your patients that choose the IDEAL IMPLANT?

“I think that my patients that have come to the conclusion that the IDEAL IMPLANT is the right implant for them, are usually very comfortable and happy in their decision. Most of my patients, no matter what type of implant they use, are usually very happy with their breast augmentation outcome because I’ve involved them in the process of helping them decide how big they are and where the incision sites are going be. They have almost full control over deciding the outcome. My IDEAL IMPLANT patients seem to be very well informed and very happy with both their physical outcome and also their mental outcome as well.”

What is the recovery process after receiving a breast augmentation?

“The recovery process is fairly straightforward. If you take it easy and don’t try to over exert yourself or do more activity than is recommended, most often you will heal just fine. Problems can occur if you go back to activities too quickly or you pull or push something too heavy, then it might displace the implant or cause bleeding. The best advice is just to follow the directions that your surgeon gives you. Most of the time that’s going to be to limit your activity, use a compression bra or a sports bra, and to sometimes do some massage techniques which are shown to you usually at the first or second postoperative visit.”

What if a woman wants a breast lift and a breast augmentation?

“Some women come in and they have breasts sagging in addition to the fact that they want more volume. In those situations, I offer a breast lift at the same time as an augmentation. It does increase the complexity of the procedure a little bit, but it is convenient to be able to accomplish both of those goals at the same time. And so most often we do it that way. It changes the approach a little bit. The scarring is a little bit different, but it all depends on how much sagging and how much rejuvenation is necessary to determine the course of that. The surgery, when a breast lift is combined with an augmentation, is a little bit more complex than just having breast augmentation by itself. The cost is a little bit higher. The recovery is a little bit longer. But for most young, healthy patients without any other medical problems, the recovery period is quite simple and uncomplicated. It generally goes along without any hiccups.”

How do you address concerns about placement of the breast implant and potential scarring?

“In terms of whether I put the implants on top of the muscle or under the muscle, almost 100% of the time I recommend that women put an implant underneath the muscle. I think it offers some significant advantages and very, very few women are candidates for the other approach. Initially, in terms of some women who have already had implants put in on top of the muscle, if they come in for an exchange, for a new implant, many times in those situations, I’ll keep them in the position that they are. But for a primary breast augmentation, almost always I recommend that they go under the muscle.

“With relation to the approach and what scars to use to get that implant in, there are three main options. The underneath breast or the inframammary fold approach, that’s my most preferred and most common approach. Also the incision can be put around the areola on the underside of the areola, and that’s a viable approach. It has some advantages and some disadvantages, but certainly a useful technique when I’m already making an incision around the areola for another purpose. Then a third approach is in the armpit. It’s an option, but seemingly one that I probably use least often.”

What should women consider when searching out a plastic surgeon?

“I think it’s hard sometimes for patients to understand what doctor to go to. The first and most important thing I think women should look at is if their doctor or their intended doctor is board-certified by the American Board of Plastic Surgery. That is very easy to find out by going to the American Board of Plastic Surgery website. Once that piece is covered, I think that there are ways to find a doctor that you can trust. Word of mouth of friends or family members that have also used a doctor for a similar reason, or else somebody in the healthcare field that knows which plastic surgeons are better than the others. I think asking for advice from people that have been down the same route is a great way to start. If you don’t have any of those options available, then looking at various websites like realself.com can give you some insights into the doctors in your area that are worth seeing.

“I think that many of my patients are referred to me by word of mouth from other patients of mine that have had good outcomes. I believe that’s a really good way to find out if your surgeon is reasonable, acceptable, and willing to work with you to achieve the goals and outcomes that you desire. My patients are typically very happy with their outcomes, mostly because I start off by educating them about the options, allowing them to help in the decision-making, and then giving them the operation that they are requesting. I’m lucky enough to have a great support staff that really helps our patients both before and after surgery, and become a valuable resource in that process to be able to answer questions and help with anything that might go on.”

Considering breast implants in Fort Worth, TX? Contact Dr. Jonathan Heistein today to discuss your options. Simply call 817-820-0000 or visit www.drheistein.com. Dr. Heistein’s office is located at 521 West Southlake Boulevard, Suite 175, Southlake, TX 76092. Call today for more information on IDEAL IMPLANT® Structured Breast Implants.