A breast augmentation is a big step to take in your life’s journey. Research shows a high level of satisfaction and happiness following plastic surgery, as long as you know what to expect going in to the procedure. Dr. Kenneth Bermudez sat down to explain what you can expect during your consultation, including choosing a breast implant. Dr. Bermudez offers a wide variety of implant options for his patients in San Francisco. Breast implants are not all created equal, and it is important to pick the right one for your needs.
Tell us a little about yourself, and your plastic surgery practice.
“I am Dr. Ken Bermudez, and I’m a plastic surgeon, board certified, practicing in San Francisco. I’ve been in the Bay Area now for over 20 years. I did my medical school training, my two residencies, and I’ve been in practice here in San Francisco since the completion of my residencies. My practice is mostly an aesthetic based practice with some reconstruction, and I serve the Greater Bay Area.”
How do you guide patients who come to you for breast implants in San Francisco?
“When a patient comes in for a breast augmentation consultation, the first thing I always ask is what’s their motivation for having the breast augmentation? It’s important to understand where the patient is coming from and what their expectations are in regards to the actual procedure that they’re looking for.
“Based on their expectations and desires, then I give them kind of a menu, a list of things to consider, and I present it to them in a very unbiased fashion. For instance, I’ll say, ‘The implant can be placed above the muscle or below the muscle. Here’s the current data on what that involves in terms of long term considerations.’ I present all of the positives and negatives of each of those approaches, whether it be how the surgery is done, where the incision is made, or what type of implant we use.”
How do you present the breast implant options to your patients?
“I actually show them the implants. I have one of the more conventional saline implants. I have the IDEAL IMPLANT® Structured Breast Implant, and the silicone gel implant. I also have the smooth and the textured implant. I show them a variety of different types of products, whether it’s a shaped product or a round product, a smooth product or a textured product, and saline versus silicone. I have them feel the implant in their hands.
“I’ll tell you, nobody likes the old, conventional saline implants, the way they feel, and especially the way they look. They have a much more round projection. They’re much more unnatural looking than silicone gel or the IDEAL IMPLANT. I spend very little time showing them that implant, because immediately you can see the reaction in their faces, like, ‘ewww.’ That’s automatically, in my practice, the least favorite option.
“When presenting silicone gel versus IDEAL IMPLANT, and they actually feel it, they say, ‘Oh, those aren’t that much different from each other.’ That’s where I think it’s important to feel the tactile difference between the two. It is really important for the patient to actually manipulate them in their own hands, because I think that can help them understand the IDEAL IMPLANT is very similar to what we see in our smooth silicone gel products.
“A lot of patients haven’t heard about the IDEAL IMPLANT, but as soon as they open up their minds about the implant, then I start presenting data. The sheets that IDEAL IMPLANT gives us that compare the seven year data on IDEAL versus silicone gel in a variety of different manufacturers is invaluable, because it gives them something to look at to compare numbers. We all are very good at comparing numbers and we’re all smart people. We can always tell one is less risk than the other in terms of long term complications, and that’s going to be the salient selling point, and that has been what has sold the patient on the IDEAL IMPLANT in regards to making it a potential choice for them.”
Are your patients happy with their IDEAL IMPLANT Structured Breast Implants?
“Yesterday, I saw a patient that I did a year ago, and she’s ecstatic about her results. I could not tell just by examining her whether I did IDEAL IMPLANTs or a silicone gel, so I actually had to look in her chart and go, ‘Oh, okay, I did IDEAL,’ and it’s a beautiful result. She said, ‘I could not be happier with the result.’”
What advice do you have for other surgeons who want to begin offering IDEAL IMPLANTS?
“From surgeon to surgeon, I think the benefit is looking at a practice perspective. You want to be able to give the patient a variety of different choices, so they make an informed choice. We’re ultimately here to improve the quality of life of our patients. If we have a product that is comparable in terms of aesthetic outcomes, and has a better outcome long term, then I think it’s our responsibility as surgeons to be able to provide that to our patients. Because we ultimately want improved outcomes and I think, without sacrificing aesthetic benefit, that’s one of the main reasons why I use the IDEAL IMPLANT, and that’s what I would tell my colleague.”
What is the process for replacing a ruptured saline implant, silicone gel implant, or IDEAL IMPLANT?
“When comparing revision surgery with a saline implant or a silicone gel implant, from a surgeon’s perspective, the silicone gel implant is much more difficult. It’s much more difficult and much more common. So, even though I have a large population of saline implants back from before 2006, the revision rate on those patients is incredibly low, compared to the silicone gel implant, which we regularly see capsular contracture formation and implant leaking. Now, the implant leaking is something that, with a saline implant, the water is absorbed and we see a deflated implant. Sometimes the pocket is a little bit tight, and so we remove the old implant, open up the pocket a little bit, put in a new implant, and it’s a very simple procedure.
“With silicone gel it can be really messy, because you can have extrusion of the silicone within the capsule, or outside of the capsule. Now, if it goes outside of the capsule, then you’re digging around breast tissue to remove bits of silicone gel, which can be nearly impossible to remove 100%. I was in a surgery two weeks ago where we were doing an implant exchange, and she had a remnant of silicone gel. She had her implants done in the 1980s. She had a remnant of silicone gel out in her breast parenchyma. I was concerned that when I went to remove that little nodule of silicone gel, it would leave a defect that would affect her breast aesthetics. Luckily, it didn’t, but silicone gel ruptures are much more problematic than a saline-filled ruptured implant.”
Why do you think IDEAL IMPLANT is growing in popularity?
“I think patients are choosing it because they like the aesthetic feel of the implant. When they touch that implant and compare it to a silicone gel implant, they’re surprised on how natural it feels. There is also the reduction of long term issues, such as implant leaking and capsular contracture formation. I mean, that’s the biggest selling point, and a major reason the patients are choosing IDEAL IMPLANTS. They don’t want to have surgery every eight to ten years, and I think the IDEAL IMPLANT reduces their risk of having surgery in that short period of time.”
Considering breast implants in San Francisco? Contact Dr. Kenneth Bermudez today to discuss your options. Simply call 415-668-2122, or visit www.plasticsurgery-sf.com. Dr. Bermudez’s office is located at 525 Spruce Street #2, San Francisco, CA 94118. Call today for more information on IDEAL IMPLANT ® Structured Breast Implants.