Breast augmentation surgery is one of the most popular procedures performed in the plastic surgery industry. Many women report increased confidence, better self-esteem, and an improved quality of life after receiving breast implants. But breast implants are not considered lifetime devices and should be regularly monitored. At the Plastic Surgery Center of Hampton Roads in Virginia Beach, breast implants check-ins are encouraged and used as a helpful tool in catching any postoperative complications. In a recent interview, plastic surgeons Dr. Michael Zwicklbauer and Dr. Michael Lofgren discussed how they help their patients who might be worried about encountering any problems.
Are you getting questions from patients about the recall of certain textured implants, and what are you telling them about the situation?
Dr. Zwicklbauer: “I get a lot of questions about ALCL right now, or the breast implant-associated large cell lymphoma, and I do try to quell their fears. However, if I were a woman with a Biocell textured implant, in knowing that the number right now being quoted is about one in a little over 3,000 risk, to me, that risk is too high.
“Now the Biocell is from Allergan, and the Mentor implants are one in 82,000, 85,000 risk, and then the Sientra implants are one in 220,000 risk of having this disease because of the texturing of the implants. So for me, those who do have the Biocell or the Allergan textured implants, as much as I can, I try to help them and I’ve had several women come in and say, ‘Take them out. I don’t want them. I don’t care what you need to do. I just want peace of mind.’ And I totally support that viewpoint.
“There’s others who understand it’s major surgery to go through all that and don’t want to, and I’m okay with that too, but those people I want to say, ‘I really want to see every year. I want you to know these are the things I’m concerned about. If it should happen, let me know ASAP so I can get to work on it quickly and we can handle it in an early fashion, in which case that whole problem is curable.’”
How are you addressing patient concerns with various types of implants, including textured implants?
Dr. Lofgren: “I think the biggest thing is just an overall fear and concern that patients have. I think a large part is just educating them about what is currently known about the process, what the incidence is, and when they understand that it truly is a very small risk factor that’s associated with it, and then when they better understand also the implants that are associated with it, specifically the type of texturing … you can allay a lot of their fears with that. And then I think it’s also important to educate them as well as to some of the warning signs. If they should ever have changes in their breast or swelling, things like that, that they absolutely come in for an immediate evaluation.”
During the consultation and pre-operation process, what do you tell patients about potential complications with breast implants?
Dr. Lofgren: “I think it’s just another piece of the puzzle, that you have to provide that patient with information so that they can make an informed decision about it. I don’t think that there’s necessarily ‘bad implants.’ Some certainly have much higher risks of certain things and I wouldn’t recommend them personally, but I think, still, it’s about educating the patient, letting them know what the true risks are, what we know about the process, and how we try to mitigate those risks and get them the look that they want, the results that they want, and do it as safely as possible.”
Dr. Zwicklbauer: “For me, I try to point out to patients all the pros and cons … and have them be the one making the decision, because it’s their life, they’re the ones who are going to carry around these implants for life, not me. However, in the back of my mind, I have this kind of father-like attribute, I guess, where I don’t want to steer them into something that may cause them harm. So personally, I don’t put in textured implants at all. So for me, that has revolutionized my practice personally because I will not even consider them, and I tell them why, and if they want them, they can go to somebody else, and that’s okay if that’s really, really what they want. But I just think you can achieve a 95% result with a safe implant that’s never going to create a problem versus where another doctor may say, ‘Well, I can give you a 100% result.’ I think if you explain that to the patient, that you’re taking off any risk of getting this bad disease by not using a textured implant. I don’t use a textured implant. So that, just for me, it has changed how I practice. So, I don’t offer those anymore, personally, as much as I used to be on board with them. We used to do a lot of Style 410 Allergan implants. We were in the study originally with Allergan, and then I used a lot of the Mentor memory gels, and I had very nice results. But I still feel that you can get a very nice result without having to use that type of implant.”
What is your message to patients learning about IDEAL IMPLANT® Structured Breast Implants?
Dr. Lofgren: “I think continuing to hammer home the message, the overall safety of it. Use the data that’s out there … the lower rates of rupture by an IDEAL IMPLANT are all key pieces of it. They’re still definitely the newest kid on the block, so to speak, the newest, latest, and greatest technology … I’m a firm believer in that. I think still marketing directly to consumers is very important in getting that out there, ‘Hey, ask your surgeon about this. There are options and you don’t have to use something else. Peace of mind is worth its weight in gold … What is your peace of mind worth? Not having to worry about silent rupture or potential issues with ALCL.’ … That’s what I would focus on trying to get that message through to patients.”
Dr. Zwicklbauer: “I would agree with what [Dr. Lofgren] said about peace of mind. That’s my big discussion when I’m talking to people about choice of implants. What I’ve done since the whole shutdown by the FDA is advocate honestly. It’s an honest company … I think they need to know that. I think they need to know that this wasn’t the FDA shutting them down. I think this is a fact that the company felt an obligation to be true to their patients. And if Allergan had done that years ago with their textured implants, we wouldn’t be dealing with all this stuff right now. Because they knew this stuff years ago and didn’t do anything.”
Dr. Lofgren: “That’s a really great point. IDEAL was very proactive in voluntarily putting a halt to this production, saying, ‘We’re going to fix this issue. Yeah, it’s caused a hiccup in our production and your availability.’ But at the same time, look at Allergan. They’ve known about this issue with ALCL for many years. Scott Spear was writing about this seven to ten years ago when these first cases started to come out, and they didn’t do anything proactive about it whatsoever. And now they’re saying, ‘Oh, well we’re going to voluntarily recall it.’ It’s a voluntary recall because trust me, the FDA calls him back and says, ‘You’re going to recall them.’”
For more information about the Allergan recall, read this article released by the U.S. Food and Drug Administration (FDA). If you are in the Hampton Roads area and considering Virginia Beach breast implants, contact Dr. Michael Zwicklbauer or Dr. Michael Lofgren today to discuss your options. Simply call 757-871-0032, or visit their website. The Plastic Surgery Center of Hampton Roads is located at 895 City Center Boulevard, Suite 300, Newport News, VA, 23606. Call today for more information on IDEAL IMPLANT® Structured Breast Implants.